Increasing the ability to correctly identify latex sensitized patients using serologic tests.
Kelly-KJ; Accetta-DJ; Klancnik-M; Elms-N; Wang-ML; Hoffmann-RG; Kurup-VP
J Allergy Clin Immunol 2011 Feb; 127(2)(Suppl. 1):AB178
RATIONALE: Currently, latex allergy diagnosis relies on patient history and serologic assays. The FDA-approved serologic tests have high rates of false positive results. This study investigated whether using other serologic assays would improve our ability to confidently diagnose latex allergen sensitization. METHODS: A total of 805 health care workers underwent duplicate skin testing with Clone 600 extract (FDA IND approval #4920) using previously published methodology. On the same day, serologic testing for latex specific IgE was measured by Pharmacia ImmunoCap and 4 ELISAs using latex proteins from different products (2 powdered glove extracts, clone 600 extract, and non-ammoniated latex). The values resulting in 98% and 99% specificity for each serologic test were identified. Multivariable logistic regression with backwards elimination was performed to evaluate the test results associated with an increased risk of latex allergen sensitization. RESULTS: Multivariable logistic regression using the previously reported cut-off value for the ImmunoCap assay (0.64, specificity 99%), a positive ImmunoCap was the only significant serologic factor in determining latex sensitization by skin test. CONCLUSIONS: For borderline-positive ImmunoCap assays (value 0.35-0.64) the addition of the ELISA assay with a specific powdered glove extract can increase the ability to correctly identify people with a relevant latex sensitization.
Allergens; Allergic-dermatitis; Allergic-reactions; Allergies; Skin-exposure; Skin-irritants; Serology; Serological-techniques; Failure-analysis; Bioassays; Diagnostic-techniques; Diagnostic-tests; Quality-control; Sensitivity-testing; Sensitization; Skin-sensitivity; Health-care-personnel; Skin-tests; Proteins; Statistical-analysis; Surveillance
Journal of Allergy and Clinical Immunology