A Comparison Study of Prick Test and Chemiluminescent Assay / 대한피부과학회지

ABSTRACT

BACKGROUND: Prick test is most frequently used in clinical procedures because its simplicity and safety of application and better correlation with clinical history as well as specificity and high reproducibility. The chemiluminescent assay(CLA) is a new in vitro non-radioactive modification of radioallergosorbent test(RAST). The CLA permits quick, simultaneous detection of total and specific IgE in human serum. The CLA has shown good sensitivity, specificity, and a good correlation with the RAST and skin prick test. OBJECTIVE: The purpose of this study was to find causative allergens and to evaluate the clinical significance of CLA comparing the results of the CLA with those of the prick test in dermatologic outpatients. METHODS: We performed the prick test with 51 allergens(Bencard Ltd. Brentford, England) in 448 patients, and CLA with 35 allergens(Boehringer mannheim Korea. green cross inc.) in 280 patients with dermatologic diseases. RESULTS: 1. The positive reaction rate was highest in third decade and decreased over the age of 40 in prick and CLA. 2. The positive reaction rate of prick test(52.8%) was higher than that of CLA(25.0%). 3. The positive reaction rate to single allergens and compound allergens was 14.2% and 38.6% in the prick test and 2.5% and 22.5% in the CLA respectively. 4. In the prick test, the positive allergens, in descending order, were House dust 114(25.4%), D. farinae 88(19.6%), D. pteronyssinus 79(17.6%), Mixed inhalants 61(13.6%), and Threshing 47(10.5%). In the CLA Thistle 35(12.5%), Dandelion 31(11.1%), D. farinae 30(10.7%), D. pteronyssinus 29(10.4%), and Cat fur 12(4.3%). 5. The results of the CLA to common 2 allergens showed a concordance rate of 84.6%, sensitivity of 58.9%, and specificity of 86.1% compared with those of prick test. CONCLUSION: CLA may be a useful alternative method and shows a good correlation with the prick test. Combination of the two method results in a high diagnostic accuracy for the cause of allergic diseases.