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Background: To identify causative allergens in patients with allergic disease, we have to evaluate overall symptoms and clinical data including in vitro and in vivo tests. Recently, a new glass microfiber histamine release test (HRT) has been clinically available.Objectives: To evaluate usefulness and limit of HRT for determining allergen, we mainly compare the results of HRT and those of specific serum IgE (CAP-RAST® (Pharmacia)) in allergic children.Method: We measured HRT and CAP-RAST® in 286 children, who were treated at our department as having bronchial asthma, atopic dermatitis or others.Results: The positive rates of HRT and CAP-RAST® were 22%, 52% in inhalant allergens, and 10%, 39% in food allergens, respectively. That is, the positive rate of HRT is lower than that of CAP-RAST®, especially in egg white and mite at young age-group. This might suggest a necessity in reassessment of the level of cut off point of HRT in young-age group. Furthermore, it was demonstrated that the positive rates of HRT in food allergens were lower than those in inhalant allergens. Frequency in positive HRT was significantly higher in patients who treated with more than four kinds of drugs than those who treated with less than three kinds of drugs. Since patients who need many kinds of drugs to control their symptoms may have severe disease, the results suggest that HRT may reflect severity of allergic diseases.Conclusion: HRT is considered to be one of useful in vitro tests to determine causative allergen. The data of HRT might predict clinical severity of allergic disorders. However, there is a limit that HRT has lower sensitivity than CAP-RAST® has at young age-group in some allergens.
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日本小児アレルギー学会 | 論文

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