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Safety
of prick-tests using food allergens - sept 2006
Prick-tests to foods are usually carried out as the first step
in the diagnosis of food allergy. Severe anaphylaxis accounts
for 4.9 % of allergies in children and occurs more frequently
in adults, raising the possibility of systemic reactions to prick-tests
in highly sensitized people. Several studies published in the
literature have used commercial extracts. As for airborne allergens,
concentrations causing a skin reaction of 15 mm do not present
a risk of systemic reactions. Prick-tests to native foods--prick-in-prick
tests--have been less extensively studied. The CICBAA1 data,
from 1,138 food allergic patients of all ages, cover 34,905 prick-in-prick
tests to foods. The wheal of these prick-tests has been regulary
registered. The risk of systemic reactions can be evaluated at
0.008 %. There were no severe reactions and anti-histamine and
corticosteroid therapy were sufficient. These results are similar
to those of the large study in 2000 carried out by Devenney in
neonates (0.005%). A review of the literature reveals only a
few severe reactions in adults. The authors draw attention to
the necessary precautions: temporary contra-indication for skin
prick-tests in children and adults with grade 3 or 4 asthma,
with particular attention to such foods as all kinds of nuts,
fish, etc.
Codreanu F, Moneret-Vautrin DA, Morisset M, Guenard L, Rance F,
Kanny G, Lemerdy P. The risk of systemic reactions to skin prick-tests
using food allergens: CICBAA data and literature review. Allerg
Immunol 2006;38:52-4 |