Efficacy of Alternative Tests for Delayed‐Cyclic Food Hypersensitivity

King, William P.; Rubin, Wallace; Fadal, Richard G.; Ward, Walter A.; Trevino, Richard J.; Pierce, William B.; Stewart, Alan L.; Boyles, John H.

doi:10.1177/019459988910100312

Cited by 15 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After histamine and glycerin controls were applied, 51,52 IDT for the same 12 inhalants and 12 foods 53 was performed on all patients (Table II). All skin reactions were evaluated at 10 minutes, and a mean wheal diameter 2 mm greater than the glycerol control was considered a positive reaction.…”

Section: Methodsmentioning

confidence: 99%

Association of Otitis Media With Effusion and Allergy as Demonstrated by Intradermal Skin Testing and Eosinophil Cationic Protein Levels in Both Middle Ear Effusions and Mucosal Biopsies

Hurst

1996

The Laryngoscope

View full text Add to dashboard Cite

This study was performed to ascertain the role of allergy, as defined by skin testing and histochemical markers, in the pathogenesis of otitis media with effusion (OME). A historical perspective of allergy as it relates to OME is presented. The study included 89 patients: 48 with persistent effusion but no recent acute infection, 25 with purulent OME complicated by a superimposed infection, and 16 control subjects. All 89 patients had persistent effusion for more than 2 months and subsequently required the placement of tympanostomy tubes. Allergy was defined using the radioallergosorbent test (RAST), serum immunoglobulin E (IgE) levels, and skin tests. Allergies were present in 97% of the patients with nonacute OME. The relationship between allergy and OME was corroborated clinically in 89% of patients and was also substantiated by elevated levels of effusion eosinophil cationic protein (ECP) in 87.5% of OME patients. Histologically, polyclonal antibody staining for ECP demonstrated the presence of eosinophils in middle ear mucosal biopsy specimens. This study confirms that OME is a sign of allergic inflammation in the middle ear that is associated with an increase in eosinophils and a concomitant release of ECP into the effusion in individuals with allergy demonstrated by skin testing.

show abstract

Section: Methodsmentioning

confidence: 99%

Association of Otitis Media With Effusion and Allergy as Demonstrated by Intradermal Skin Testing and Eosinophil Cationic Protein Levels in Both Middle Ear Effusions and Mucosal Biopsies

Hurst

1996

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…Meta-analysis of the efficacy of antimicrobials for OME, as evaluated in eleven large studies, indicates increased cure rates of only 22.0% (95% C1, 15.2% to 28.9% V It is obvious that there is no simple answer.…”

mentioning

confidence: 99%

The Presence of Eosinophil Cationic Protein in Middle Ear Effusion

Hurst

1993

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Eosinophil cationic protein (ECP) is probably responsible for the underlying inflammatory mechanisms seen in asthma. It can be modulated in vivo by immunotherapy or steroids, with an appropriate reduction in symptoms of respiratory tract diseases. ECP is an identifiable mediator in additional target organs involved in allergic reactions, making it of potential interest in the study of otitis media with effusion. A qualitative prospective study was designed to discover the relationship of ECP and serum IgE in patients with middle ear effusion and allergy, as demonstrated by RAST and skin testing. The concentrations of ECP in the middle ear fluid from 23 consecutive patients with otitis media with effusion undergoing the placement of tympanostomy tubes ranged from 2 to 1248 micrograms (normal serum ECP, 5 to 15 micrograms), with 87% being abnormally elevated. There was no correlation between an individual's ear and serum levels of ECP (r = 0.1672; p = 0.6232), suggesting a more localized process. There was no relation between effusion ECP and serum IgE (p = 0.0040). ECP from middle ear effusion did correlate with a patient's having allergy, as confirmed by RAST and skin testing (p = 0.0095). Mechanisms involving immune mediated disease in the middle ear, of which the eosinophil may be one participant, are presented.

show abstract

“…The poor correlation of SPT and in vitro tests with clinical symptoms likely reflects the number of people with non‐IgE‐mediated reactions to foods. In the absence of other sensitive, specific laboratory tests for food allergy, IDT has been used to test for non‐IgE‐mediated food reactions, and avoids the inconvenience and risk of multiple oral challenges. Yet current guidelines state, based primarily on opinion, and not on data, that there is significant risk to food IDT …”

Section: Discussionmentioning

confidence: 99%