Murat Cem MİMAN, Orhan ÖZTURAN, Tamer ERDEM, İbrahim H. ÖZEROL

Atopi veya alerjili olgularda alerjen-spesifik IgE düzeyleri

Amaç: Öykü ve fizik muayene ile alerjik veya atopikolarak değerlendirilen olgularda spesifik IgE bakısının tanıdaki yeri değerlendirildi.Hastalar ve Yöntemler: Rinit, astım veya dermatitli143 eriflkin ve 113 çocukta serum spesifik IgE düzeyleri ölçüldü. Ölçümler kemilüminesans tekniği ile yapıldı;elde edilen sonuçlar altı grupta değerlendirildi spesifik IgE saptanmayan ya da çok düflük düzeyde saptanan olgular, düflük, orta, yüksek ve çok yüksek düzeyler . Spesifik IgE düzeyinin 0.70 IU/ml pozitif sonuçfleklinde yorumlandı. Eriflkinlerde 35 ayrı alerjeniçin, çocuklarda ise 19 ayrı alerjen için spesifik IgEdüzeylerine bakıldı.Bulgular: Eriflkinlerin %64.34’ünde 92 olgu , çocukların %44.25’inde 50 olgu pozitif spesifik IgEdüzeyi >0.70 IU/ml saptandı. Tek tek alerjenlerekarflı duyarlılık eriflkinlerde %20.08 ile %41.96; çocuklarda %17.70 ile %28.32 arasında değiflmekteydi. Sadece tek bir alerjene duyarlılık eriflkinlerde 14olguda, çocuklarda sekiz olguda görüldü; diğer olgularda en az iki alerjene karflı duyarlılık saptandı.So n u ç : Benzer semptomlara sahip hastalıklarda alerjik etyolojinin ortaya konmasında alerjenlere duyarlılığıölçen serumda spesifik IgE bakısı gibi testler, öykü vefizik muayene bulgularını destekleyici niteliktedir

Anahtar Kelimeler:

Alerjen/immünoloji, hipersensitivite/kan/ tanı, immünglobulin E/analiz/immünoloji.

Determination of allergen-specific IgE in patients with atopy or allergy symptoms

Objectives: We investigated the role of specific IgE assay in the diagnosis in patients found to be atopic or allergic by history and physical examination.Patients and Methods: Serum specific IgE levels were measured by the chemiluminescent assay in 143 adults 58 females, 85 males; mean age 34.3 years; range 16 to 62 years and in 113 children 62 giriş, 51 boys; mean age 10.2 years; range 5 to 16 years with rhinitis, asthma, or dermatitis. The results were analyzed in six groups depending on the specific IgE level no specific IgE, very low, low, moderate, high, and very high levels . The specific IgE threshold for a negative or positive result was accepted as 0.70 lU/ml. Allergen-specific IgE anti- bodies were sought for 35 allergens in adults, and for 19 allergens in children.Results: Specific IgE levels were positive >0.70 lU/ml in 92 adults 64.34% and in 50 children 44.25% . Hypersensitivity to individual allergens ranged between 20.08% and 41.96% in adults, and between 17.70% and 28.32% in children. Fourteen adults and eight children showed sensitivity to a sin- gle allergen; the remaining patients were sensitive to at least two allergens.Conclusion: Detection of sensitivity to allergens is complementary to findings obtained by history and physical examination and may help to reveal allergic etiology in patients presenting with a similar symptom profile.

Keywords:

Allergens/immunology, hypersensitivity/blood/ diagnosis, immunoglobulin E/analysis/immunology,

PDF

___

Durham RS, Church MK. Principles of allergy diagno- sis. In: Holgate ST, Church MK, Lichtenstein LM, edi- tors. Allergy. 2nd ed. London: Elsevier Science; 2002. p. 3-16.
Selner JC, Sullivan TJ, Ahlstedt S, Claman HN, Dolen WK, Nelson HS, et al. Current issues relating to in vitro testing for allergen-specific IgE: a workshop report. Ann Allergy Asthma Immunol 1999;82:407-12.
Ahlstedt S. Understanding the usefulness of specific IgE blood tests in allerg y. Clin Exp Allergy 2002; 3 2 : 11 - 6 .
Çanakçıoğlu S, Papila İ. Sivas yöresindeki allerjik rinit- li hastalarda prik test sonuçları. Karadeniz Tıp Dergisi 1991;4:164-6.
Yunginger JW, Ahlstedt S, Eggleston PA, Homburger HA, Nelson HS, Ownby DR, et al. Quantitative IgE antibody assays in allergic diseases. J Allergy Clin Immunol 2000;105(6 Pt 1):1077-84.
Plebani M, Borghesan F, Faggian D. Allergy diagnosis. Ann Allergy Asthma Immunol 1996;76:295-6.
P a s t o rello EA, Incorvaia C, Ortolani C, Bonini S, Canonica GW, Romagnani S, et al. Studies on the relationship between the level of specific IgE anti- bodies and the clinical expression of allergy: I. Definition of levels distinguishing patients with symptomatic from patients with asymptomatic aller- gy to common aero a l l e rgens. J Allergy Clin Immunol 1995;96(5 Pt 1):580-7.
Kelso JM, Sodhi N, Gosselin VA, Yunginger JW. Diagnostic performance characteristics of the stan- d a rd Phadebas RAST, modified RAST, and pharma- cia CAP system versus skin testing. Ann Allerg y 1 9 9 1 ; 6 7 : 5 11 - 4.
Wood RA, Phipatanakul W, Hamilton RG, Eggleston PA. A comparison of skin prick tests, intradermal skin tests, and RASTs in the diagnosis of cat allergy. J Allergy Clin Immunol 1999;103(5 Pt 1):773-9.
B rown CR, Higgins KW, Frazer K, Schoelz LK, Dyminski JW, Marinkovich VA, et al. Simultaneous determination of total IgE and allergen-specific IgE in serum by the MAST chemiluminescent assay system. Clin Chem 1985;31:1500-5.
Bonetti SM, Bonizzato CM, Piacentini GL, Verga A, Harris RI, Boner AL. Relationships between skin prick test, radioallergosorbent test, and chemiluminescent assays in allergic children. Ann Allergy 1991;66:137-41.
Nickel R, Kulig M, Forster J, Bergmann R, Bauer CP, Lau S, et al. Sensitization to hen’s egg at the age of twelve months is predictive for allergic sensitization to common indoor and outdoor allergens at the age of three years. J Allergy Clin Immunol 1997;99:613-7.
Kulig M, Bergmann R, Tacke U, Wahn U, Guggenmoos-Holzmann I. Long-lasting sensitization to food during the first two years precedes allergic air- way disease. The MAS Study Group, Germany. Pediatr Allergy Immunol 1998;9:61-7.
Sensi LG, Piacentini GL, Nobile E, Ghebregzabher M, B runori R, Zanolla L, et al. Changes in nasal specific IgE to mites after periods of allergen exposure-avoidance: a comparison with serum levels. Clin Exp Allergy 1994;24: 3 7 7 - 8 2 .
Szeinbach SL, Barnes JH, Sullivan TJ, Williams PB. P recision and accuracy of commercial laboratories’ ability to classify positive and/or negative allerg e n - specific IgE results. Ann Allergy Asthma Immunol 2001; 8 6 : 3 7 3 - 8 1 .
Topuz B. Allerjik rinit tanısında kullanılan testler. In: D o ğ ru H, Topuz B, editörler. Kulak burun boğaz hastalıklarında allerjik hastalıklar. Isparta: Hamle Yayınevi; 2001. s. 25-40.

The Turkish Journal of Ear Nose and Throat-Cover

ISSN: 2602-4837
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1991
Yayıncı: İstanbul Üniversitesi

Arşiv