High prevalence of skin test positivity in severe or difficult-to-treat asthma.

Abstract

BACKGROUND:

Skin tests are considered the gold standard for detecting allergen-specific immunoglobulin E (IgE) in the clinical setting and are an important tool for diagnosing and managing allergic asthma.

OBJECTIVE:

To assess the prevalence of skin testing in patients > or = 12 years enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study.

METHODS:

Patients were asked whether they had ever been skin tested and, if so, they were asked to provide the test results. Clinical characteristics were used to compare positive (ST+), negative (ST-), and skin test not done (STND) patients.

RESULTS:

Of 2,985 patients eligible, 85.8% recalled being skin tested. Of those tested, 93.5% were positive (allergist 95.7%, pulmonologist 87.3%). A high proportion of Whites (93.5%) and non-Whites (94.0%) were ST+; however, more non-Whites had never been skin tested (21.7% vs. 12.3%, respectively; p < 0.0001). Total serum IgE was 104.6 IU/mL for ST+ patients, 87.1 IU/mL for STND patients, and 32.4 IU/mL for ST- patients. Age at asthma onset, duration of asthma, and the prevalence of atopic disorders and asthma triggers differentiated the ST+ from the ST- group. Disease severity appeared similar between the two groups. In general, values for STND patients were closer to the ST+ group, suggesting that those not tested would have been ST+ if administered a test.

CONCLUSIONS:

The prevalence of ST+ patients was high in allergy and pulmonology practices, and in White and non-White patients. These data support the utility of a more complete allergic evaluation in severe asthmatics. Skin testing appears associated with disease pathophysiologies in asthma.

• Authors: Tmirah Haselkorn, Larry Borish, Dave P Miller, Scott T Weiss, Dennis A Wong
• Journal: The Journal of asthma : official journal of the Association for the Care of Asthma (J Asthma) Vol. 43 Issue 10 Pg. 745-52 (Dec 2006) ISSN: 0277-0903 [Print] England
• PMID: 17169826 (Publication Type: Journal Article)

Chemical References

• Allergens
• Immunoglobulin E

Topics

• Adult
• Age of Onset
• Aged
• Allergens (immunology)
• Allergy and Immunology (statistics & numerical data)
• Asthma (diagnosis, immunology, physiopathology, therapy)
• Female
• Humans
• Hypersensitivity (complications, epidemiology)
• Immunoglobulin E (blood)
• Male
• Middle Aged
• Prevalence
• Pulmonary Medicine (statistics & numerical data)
• Severity of Illness Index
• Skin Tests (statistics & numerical data)
• White People (statistics & numerical data)