The incidence and features of systemic reactions to skin prick tests.

Abstract

BACKGROUND:

Skin prick testing (SPT) has been regarded as a safe procedure with few systemic reactions.

OBJECTIVE:

To evaluate the rate of systemic reactions and their associations after SPT in the largest population to date.

METHODS:

In this study reactions were recorded prospectively in a specialist UK allergy clinic for 6 years (2007-2013). An estimated 31,000 patients underwent SPT.

RESULTS:

Twenty-four patients (age range 7 months to 56 years, mean 23.5 years, 17 female patients, 12 with asthma) had systemic reactions. The rate of systemic reactions to SPT was 0.077%. The likely allergens causing the reaction were foods (18; peanut, 7; walnut, 1; Brazil nut, 2; pistachio, 1; lupin, 1; cow's milk, 2; shrimp, 1; spinach, 1; legume, 1; soy, 1), aeroallergens (4; rabbit, 1; rat, 1; ragwort, 1; grass pollen, 1), wasp venom (1), and Tazocin (1). The causative SPT wheal was larger than 8 mm in 75%. The reaction to Tazocin was severe, with anaphylaxis occurring minutes after SPT. Reactions were treated immediately in the clinic and did not require further medical care.

CONCLUSION:

In this largest single-center study, the rate of systemic reactions after SPT was 77 per 100,000 patients. It is the first study to identify foods as a common and important cause (75%), with nuts posing the highest risk. This study reports the first systemic reaction to venom SPT and the first anaphylactic reaction after drug SPT. There was an association with a history of severe reactions and large skin test reaction. There are risks, albeit small, when undertaking SPT.

• Authors: Priya Sellaturay, Shuaib Nasser, Pamela Ewan
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 115 Issue 3 Pg. 229-33 (Sep 2015) ISSN: 1534-4436 [Electronic] United States
• PMID: 26254972 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Piperacillin, Tazobactam Drug Combination
• Penicillanic Acid
• Piperacillin

Topics

• Adolescent
• Adult
• Allergens (immunology)
• Anaphylaxis (immunology)
• Child
• Child, Preschool
• Erythema (immunology)
• Female
• Food Hypersensitivity (immunology)
• Humans
• Infant
• Male
• Middle Aged
• Nut Hypersensitivity (immunology)
• Penicillanic Acid (analogs & derivatives, immunology)
• Piperacillin (immunology)
• Piperacillin, Tazobactam Drug Combination
• Prospective Studies
• Retrospective Studies
• Skin Tests (adverse effects)
• Urticaria (immunology)
• Young Adult