PROVOCATION-CHALLENGE STUDIES IN SHRIMP-SENSITIVE INDIVIDUALS

PROVOCATION-CHALLENGE STUDIES IN SHRIMP-SENSITIVE INDIVIDUALS
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DOI:
10.1016/0091-6749(88)90888-3
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发表时间:
1988-06-01
影响因子:
14.2
通讯作者:
LEHRER, SB
LEHRER, SB
中科院分区:
医学1区
文献类型:
--
作者:
DAUL, CB;MORGAN, JE;LEHRER, SB

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Thirty individuals with history of immediate, objective, adverse reactions after shrimp ingestion underwent double-blind, placebo-controlled shrimp-food challenges. All individuals who did not exhibit a positive response (reproduction of objective symptoms) were administered an open challenge of 16 whole cooked shrimp. Positive challenge responses occurred in 9/30 subjects (30%); six of these subjects experienced a positive response during the double-blind phase. Of the 21 remaining subjects, 12 experienced generalized pruritus as their only symptom, whereas nine subjects had completely negative challenge responses. All placebo challenges were negative. Although a positive skin test was strongly associated with challenge symptoms (p < 0.001), the shrimp prick skin test titration end points were not different among the challenge groups. The serum shrimp RAST percent was significantly higher in the positive challenge group (p < 0.02). Mean levels of shrimp-specific serum IgG, IgA, and IgM levels were not different among the challenge groups. Although no single immunologic variable could be consistently used to identify subjects more likely to exhibit a positive challenge response, the composite of a positive shrimp prick skin test and elevated serum shrimp-specific IgE (RAST percent label bound > 11%) demonstrated a correct predictive value of 87% in this group of shrimp-sensitive subjects.