False-Positive Results of Serological Tests for Allergy in Alcoholic Patients.

BACKGROUND AND OBJECTIVE: Alcohol consumption is associated with enhanced TH2 immune responses. Objective: To investigate the frequency of false-positive results in serological tests for allergy in alcoholic patients. METHODS: A total of 138 alcoholic patients consecutively admitted to hospital underwent a panel of allergy tests that included serum total IgE, a multiallergen IgE test (UniCAP Phadiatop), and skin prick tests to relevant aeroallergens in the area, which were considered the standard reference for atopy. In selected cases with positive specific IgE (sIgE) to cross-reactive carbohydrate determinants (CCDs) on ImmunoCAP, we determined sIgE to hymenoptera venom components (ADVIA Centaur) and a microarray of 103 allergen components (ISAC). RESULTS: Increased serum total IgE (>170 IU/mL) was observed in 59/110 (54%) of nonatopic (skin prick test-negative) patients. The result of the multiallergen IgE test was positive in 46 nonatopic patients (42%). This finding was closely associated with high serum concentrations of total IgE and sIgE to CCDs. The vast majority of patients with positive CCD-sIgE showed positivity to glycosylated plant and hymenoptera allergen components on ISAC and ADVIA Centaur. Only 1 out of 26 patients with positive sIgE to CCD and hymenoptera venom developed honeybee venom allergy after a median follow-up of 166 months. Correlations between measurements of sIgE to CCD markers on ImmunoCAP, ADVIA Centaur, and ISAC were imperfect. CONCLUSIONS: Serological tests for allergy should be interpreted with caution in alcoholic patients, who frequently have increased levels of total IgE and CCD-sIgE and subsequent positivity of sIgE to glycosylated allergen components, irrespective of the method used.

False-positive results of serological tests for allergy in alcoholic patients

Background: Alcohol consumption is associated with enhanced TH2 immune responses. Objective: To investigate the frequency of false-positive results in serological tests for allergy in alcoholic patients. Methods: A total of 138 alcoholic patients consecutively admitted to hospital underwent a panel of allergy tests that included serum total IgE, a multiallergen IgE test (UniCAP Phadiatop), and skin prick tests to relevant aeroallergens in the area, which were considered the standard reference for atopy. In selected cases with positive specific IgE (sIgE) to cross-reactive carbohydrate determinants (CCDs) on ImmunoCAP, we determined sIgE to hymenoptera venom components (ADVIA Centaur) and a microarray of 103 allergen components (ISAC).Results: Increased serum total IgE (>170 IU/mL) was observed in 59/110 (54%) of nonatopic (skin prick test-negative) patients. The result of the multiallergen IgE test was positive in 46 nonatopic patients (42%). This finding was closely associated with high serum concentrations of total IgE and sIgE to CCDs. The vast majority of patients with positive CCD-sIgE showed positivity to glycosylated plant and hymenoptera allergen components on ISAC and ADVIA Centaur. Only 1 out of 26 patients with positive sIgE to CCD and hymenoptera venom developed honeybee venom allergy after a median follow-up of 166 months. Correlations between measurements of sIgE to CCD markers on ImmunoCAP, ADVIA Centaur, and ISAC were imperfect. Conclusions: Serological tests for allergy should be interpreted with caution in alcoholic patients, who frequently have increased levels of total IgE and CCD-sIgE and subsequent positivity of sIgE to glycosylated allergen components, irrespective of the method used

Antecedentes: El consumo de alcohol se asocia con respuestas inmunes aumentadas de tipo Th2.Objetivo: Investigar la frecuencia de falsos positivos en los tests serológicos de alergia en alcohólicos. Métodos: En un total de 138 pacientes alcohólicos ingresados en el hospital de forma consecutiva se realizó un panel de pruebas de alergia que incluyó la determinación de IgE sérica total, un test de IgE específica multialergeno (UniCAP Phadiatop) y pruebas cutáneas en prick a una batería de aeroalérgenos relevantes en el área, cuya positividad se consideró la referencia para clasificar a los pacientes como atópicos. En casos seleccionados con positividad de IgE específica (sIgE) frente a carbohidratos con reactividad (CCDs) en el ImmunoCAP, se determinó la sIgE a componentes del veneno de hymenópteros (ADVIA Centaur) y a un microarray de 103 componentes alergénicos (ISAC).Resultados: Se observó un aumento de las concentraciones de IgE sérica total (>170 IU/mL) en 59/110 (54%) de los alcohólicos no atópicos (prick test-negativos). Cuarenta y seis alcohólicos no atópicos (42%) presentaban un test de IgE específica multialérgeno positivo. Este hallazgo estuvo estrechamente asociado con la presencia de concentraciones elevadas de IgE total y de sIgE a CCDs. La gran mayoría de los alcohólicos con positividad de sIgE a CCDs mostraron positividad con componentes moleculares glicosilados de plantas e himenópteros en el ISAC y el ADVIA Centaur. Sólo uno de los 26 pacientes con positividad de sIgE a CCDs e himenópteros desarrolló alergia clínica a picadura de abeja tras un seguimiento mediano de 166 meses. La correlación de las determinaciones de sIgE a marcadores de CCD en ImmunoCAP, ADVIA Centaur e ISAC fue imperfecta. Conclusiones: Los tests serológicos de alergia se deben interpretar con precaución en pacientes alcohólicos, que frecuentemente muestran elevación de IgE total, positividad de sIgE a CCDs y, consecuentemente, positividad de sIgE a componentes alergénicos glicosilados, independientemente del método utilizado

Paucisymptomatic infectious prostatitis as a cause of fever without an apparent origin. A series of 19 patients.

According to the literature, prostatitis is a rare cause of prolonged fever without an apparent origin. However, this syndrome can be easily diagnosed using specific tests, either two-glass pre- and post-prostatic massage or the Meares-Stamey four-glass test. A retrospective study over a 5-year period (between August 1st 2006 and July 31st 2011) was performed. All patients who met the criteria for microbiological prostatitis were included and assigned to one of two groups, either a study group [paucisymptomatic infectious prostatitis (PIP)] or a control group [classic infectious prostatitis (CIP)]. Epidemiological, clinical, microbiological, and treatment-related variables were collected. A comparative study between both groups was performed. Thirty-nine patients were diagnosed with prostatitis. The main risk factors were unprotected anal intercourse, human immunodeficiency virus (HIV) infection, recent travel, and recurrent urinary tract infections. The most significant differences between the PIP (19 patients) and CIP (20 patients) groups were higher frequency of elevated inflammatory markers, higher frequency of monomicrobial etiology, and longer treatment. In monomicrobial prostatitis, the most common causative agents were coagulase-negative Staphylococcus spp., Escherichia coli, and Corynebacterium glucuronolyticum. According to the findings of this study, we believe that prostatitis should be included as a possible diagnosis in a man who complains of prolonged fever without an apparent origin and having at least one of the following risk factors: unprotected anal intercourse, HIV infection, recent travel, and recurrent urinary tract infections.