The risk of systemic reactions to skin prick-tests using food allergens: CICBAA data and literature review

Eur Ann Allergy Clin Immunol. 2006 Feb;38(2):52-4.

Abstract

Prick-tests to foods are usually carried out as the first step in the diagnosis of food allergy. Severe anaphylaxis accounts for 4.9 % of allergies in children and occurs more frequently in adults, raising the possibility of systemic reactions to prick-tests in highly sensitized people. Several studies published in the literature have used commercial extracts. As for airborne allergens, concentrations causing a skin reaction of 15 mm do not present a risk of systemic reactions. Prick-tests to native foods--prick-in-prick tests--have been less extensively studied. The CICBAA1 data, from 1,138 food allergic patients of all ages, cover 34,905 prick-in-prick tests to foods. The wheal of these prick-tests has been regulary registered. The risk of systemic reactions can be evaluated at 0.008 %. There were no severe reactions and anti-histamine and corticosteroid therapy were sufficient. These results are similar to those of the large study in 2000 carried out by Devenney in neonates (0.005%). A review of the literature reveals only a few severe reactions in adults. The authors draw attention to the necessary precautions: temporary contra-indication for skin prick-tests in children and adults with grade 3 or 4 asthma, with particular attention to such foods as all kinds of nuts, fish, etc.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allergens / adverse effects*
  • Anacardium / adverse effects
  • Angioedema / etiology*
  • Animals
  • Child
  • Child, Preschool
  • Databases, Factual / statistics & numerical data
  • Eggs / adverse effects
  • Female
  • Fishes
  • Food Hypersensitivity / complications*
  • Histamine Release
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Peanut Hypersensitivity / complications
  • Risk
  • Seafood / adverse effects
  • Skin Tests / adverse effects*
  • Urticaria / etiology*

Substances

  • Allergens