Baur X, Czuppon A, Diagnostic Validation Of Specific Ige Antibody Concentrations, Skin Prick Testing, And Challenge Tests In Chemical Workers With Symptoms Of Sensitivity To Different Anhydrides, J Allergy Clin Immunol, 1995;96:489-494,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

9 anhydride workers, who complained of various respiratory symptoms, were studied. 4/9 had immediate-type skin prick test (SPT) responses to one or more conjugates and had elevated IgE concentrations in addition to 2 other workers. 3/6 of six nasal challenges and 4/9 bronchial challenges resulted in positive responses. All but one of the positive nasal or bronchial test responses were associated with elevated IgE levels. The 7 positive challenge test results included 5 positive SPT. In all but 2 of the subjects with negative challenge test results, no specific IgE could be detected. In these 2 subjects the negative results were associated with low levels of IgE, and in one, with the absence of asthma. Anhydrides investigated in this study can induce IgE-mediated hypersensitivity, which can be diagnosed by using the respective human serum albumin in estimation of specific IgE and in skin, nasal, and bronchial challenge tests. Estimation of IgE was demonstrated to be more sensitive than SPT.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 2+ Both skin prick and serological tests are highly sensitive for detecting specific IgE and occupational asthma caused by most high molecular weight agents, but are not specific for diagnosing asthma.

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