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

AbstractBACKGROUND:
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.
AuthorsPriya Sellaturay, Shuaib Nasser, Pamela Ewan
JournalAnnals 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
PMID26254972 (Publication Type: Journal Article)
CopyrightCopyright © 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)
  • Prospective Studies
  • Retrospective Studies
  • Skin Tests (adverse effects)
  • Urticaria (immunology)
  • Young Adult

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