Comparison of Intradermal Dilutional Testing,Skin Prick Testing,and Modified Quantitative Testing for Common Allergens

Abstract

OBJECTIVES: To compare and correlate wheal size using the Multi-Test II applicator with the endpoint obtained by intradermal dilutional testing (IDT) for 5 common allergens. To examine the safety of modified quantitative testing (MQT) for determining immunotherapy starting doses.

STUDY DESIGN: Prospective comparative clinical study.

SUBJECTS AND METHODS: A total of 134 subjects were simultaneously skin tested for immediate hypersensitivity using the Multi-Test II device and IDT.

RESULTS: There was a 77% concordance between results from IDT and results from MQT. When there was a difference, MQT predicted a safer endpoint for starting immunotherapy in all but 2 cases.

CONCLUSION: Wheal size by SPT is predictive of endpoint by IDT. MQT is nearly as effective as formal IDT in determining endpoint.

SIGNIFICANCE: Modified quantitative testing appears to be a safe alternative to IDT for determining starting doses for immunotherapy.

Get full access to this article

View all access options for this article.

References

Krouse

Chadwick

Gordon

. Allergy and immunology. An otolaryngic approach. Chapter 8. Phladelphia: Lippincott Williams & Wilkins; 2002. p. 115–22. (Grade D).

King

Mabry

Allergy in ENT practice: a basic guide. New York: Thieme Medical Publications; 1998. (Grade D).

Krouse

Mabry

Skin testing for inhalant allergy 2003: Current strategies. Otolaryngol Head Neck Surg 2003;129(4 Suppl):S33–49. (Grade D).

Wood

Phipatanakul

Hamilton

. A comparison of skin prick tests, intradermal skin tests, and RAST in the diagnosis of cat allergy. J Allergy Clin Immunol 1999;103:773–9. (Grade B).

Gungor

Houser

Aquino

. A comparison of skin end-point titration and skin-prick testing in the diagnosis of allergic rhinitis. Ear Nose Throat J 2004;83(1):54–60. (Grade B).

Krouse

Sadrazodi

Kerswill

Sensitivity and specificity of prick and intradermal testing in predicting response to nasal provocation with timothy grass antigen. Otolaryngol Head Neck Surg 2004;131(3):215–9. (Grade B).

Krouse

Shah

Kerswill

Skin testing in predicting response to nasal provocation with Alternaria. Laryngoscope 2004;114(8):1389–93. (Grade B).

Peltier

Ryan

Comparison of intradermal dilutional testing with the Multi-Test II applicator in testing for mold allergy. Otolaryngol Head Neck Surg 2006;134(2):240–4. (Grade B).

Simons

Rubinstein

Kogut

. Comparison of Multi-Test II skin prick testing to intradermal dilutional testing. Otolaryngol Head Neck Surg 2004;130(5):536–44. (Grade C).