18例老年过敏性哮喘粉尘螨10年脱敏治疗的观察

本文从多年对过敏性哮喘患者的脱敏治疗经验进行分析、总结 ,揭示过敏性哮喘患者发病机制 ,寻找治疗该病的最佳方法。1　材料与方法18例患者均为粉尘螨过敏 ,并经 10年以上脱敏治疗的过敏性哮喘病人 ,男 4例 ,女 14例 ;年龄 4 8～ 81岁 ,平均年龄 6 5岁 ;病程均在 30年以上。其中18例过敏性哮喘患者中 15例伴过敏性鼻炎。粉尘螨特异性ＩｇＥ强阳性 ,血清总ＩｇＥ >30 0Ｕ/ｍｌ;血清间接阻断抗体试验皮试阳性。以 1∶10 0 0 0 0 0粉尘螨为起始浓度 ,0 1ｍｌ的量开始依次递增 ,进行脱敏治疗 ,1次 /ｗ ,8次为一疗程 ,最终浓度是 1∶10 0 0 ,维…     

青霉素类过敏反应病人血清中特异性IgE抗体

目的 :探讨青霉素类过敏反应与特异性IgE抗体的关系。方法 :采用放射过敏原吸附试验 (RAST)测定 3 97例青霉素过敏病人血清中 8种抗原决定簇(BPO PLL、PVO PLL、APO PLL、AXO PLL、BPA PLL、PVA PLL、APA PLL、AXA PLL)特异性IgE抗体。结果 :3 97例过敏病人中 ,特异性IgE抗体阳性率为 5 8.9% (2 3 4例 )。其中 ,男性组抗体阳性率显著高于女性组 (P <0 .0 5 )。在所检测的 8种特异性IgE抗体中 ,BPA IgE抗体阳性率 2 5 .44% (1 0 1例 )最高 ,PVA IgE抗体 2 5 .1 9% (1 0 0例 )次之 ,而APA IgE抗体 9.82 % (3 9…     

过敏性哮喘患者痰中粉尘螨特异性IgE和总IgE检测

本文用BA-ELISA测定100例过敏性哮喘患者的痰和血清中粉尘螨特异性IgE和总IgE,结果表明,68例粉尘螨过敏性哮喘患者的痰和血清中特异性IgE、总IgE水平高于32例非粉尘螨过敏性哮喘患者,两者有非常显著性差异(P<0.001)。在粉尘螨过敏性哮喘患者痰中特异性IgE、总IgE亦明显高于血清。选择22例哮喘患者经减敏治疗半年后,多数病例痰和血清中特异性IgE、总IgE均有下降,治疗前后差异显著(P<0.001)。     

广州地区支气管哮喘患者常见吸入变应原调查分析

目的　调查广州地区支气管哮喘发病相关的主要致敏变应原 .方法　对 10 2例支气管哮喘缓解期患者 ,其中儿童 4 8例 ,成人 5 4例 ,用尘螨、霉菌、猫毛等 12种常见吸入变应原进行皮肤点刺试验 ,并测定其中 2 7例总IgE(TIgE)的水平 .结果　儿童组尘螨皮试阳性率最高 (均为 79.2 % ) ,其次是屋尘 (72 .9% ) .成年组尘螨皮试阳性率最高 ,粉尘螨和屋尘螨分别为 5 9.3%、6 2 .9% ,其次为屋尘 (4 0 .7% ) .在动物毛发皮屑中 ,以狗毛为主 ,猫毛次之 ;对于所有变应原 ,儿童组的阳性百分率远远高于成年组 ;2 7例血清总IgE的均值为 5 0 6 .1KU/L ,远高于正常人 ,其中皮试阳性者TIgE水平高于皮试阴性者 (p<0 .0 1) .结论　广州地区主要变应原均为尘螨 ,且哮喘儿童对尘螨过敏的阳性率显著高于成人     

过敏性紫癜儿童血清过敏原特异性IgE抗体检测分析及与空气质量关系的初步研究

目的：分析过敏性紫癜（HSP）患儿血清过敏原谱分布并探讨其发病及其与空气质量的关系。方法：以2019年11月至2021年10月于天津市儿童医院住院的116例HSP患儿为研究对象;采用酶联免疫捕获法定量检测血清过敏原特异性IgE抗体水平,分析HSP患儿血清过敏原谱分布;收集同时间段天津市空气质量监测数据,探讨HSP发病及其与空气质量的关系。结果：116例HSP患儿血清中,有特异性IgE抗体检测阳性患者63例,阳性率54.31%,其中一种过敏原阳性35例,阳性率30.17%,两种及两种以上过敏原阳性28例,阳性率24.14%。食入性过敏原中以鸡蛋、牛奶及小麦面粉阳性率最高,分别为31.03%、12.07%和8.62%;吸入性过敏原中以粉尘螨、交链孢霉及屋尘阳性率最高,分别为15.52%、12.93%和8.62%。不同性别HSP患儿总特异性IgE抗体阳性检出率差异无统计学意义（P>0.05）,女性患儿对牛奶过敏的阳性检出率高于男性,差异有统计学意义（P<0.05）。HSP好发于学龄前期儿童,且年龄越小对鸡蛋、交链孢霉过敏的阳性检出率越高,差异均有统计学意义（P<0.05）。...     

AD患者血清IgE与单个核细胞中cAMP-PDE活性关系的临床意义

<正> Atopy是指一组过敏性哮喘、过敏性鼻炎及遗传过敏性皮炎(Atopic Dermatitis,AD)的疾病。已报道大多数AD患者血清IgE水平增高。实验证明,Atopy患者的B细胞体外自发性产生过量IgE,且与胞内环核苷酸磷酸二酯酶(cAMP-PDE)活力增高密切相关。本文观察了AD及其亚型患者血清总IgE及粉尘螨特异性IgE水平,并初步探讨了血清IgE与cAMP-PDE间的关系。     

青霉素皮肤试验与特异性IgE

目的 :探讨青霉素皮试与青霉素过敏病人血清中特异性IgE抗体相关性 ,评价皮试的准确性与特异性 ,改进和完善该类药物过敏的诊断方法。方法 :收集青霉素皮试阳性史者、青霉素皮试阳性即刻者和青霉素皮试阴性用药后出现过敏症状者三种过敏病人血清 ,共计 2 5 9例 ,采用放射过敏原吸附试验法 (ra dioallergsorbenttest,RAST)检测青霉素过敏病人血清中特异性IgE抗体。结果 :青霉素过敏病人血清特异性IgE抗体总阳性率为 62 .2 % (1 61 / 2 5 9) ;青霉素皮试阳性史者、青霉素皮试阳性即刻者和青霉素皮试阴性用药后出现过敏症状者三组之间特异…     

北京地区尘螨过敏患者特异性IgE水平分析

目的了解北京地区不同年龄、性别尘螨过敏患者对尘螨敏感性差异。方法本研究采用回顾性横断面研究,纳入我科2016年8月至2017年7月因过敏性疾病就诊、户尘螨或粉尘螨至少一项sIgE阳性患者318例。分别比较户尘螨及粉尘螨sIgE水平差异以及不同性别、年龄患者尘螨sIgE水平差异。结果两种尘螨sIgE水平差异无统计学意义(P=0.336)。男性患者血清特异性IgE(sIgE)平均水平明显高于女性患者(P=0.009),其中男性特重度过敏患者所占比例明显高于女性(P<0.001),但女性中度过敏患者所占比例明显高于男性(P=0.01)。年龄与抗体水平呈明显负相关(R=-0.217,P<0.001)。婴幼儿、儿童、少年组中特重度过敏患者所占比例最高,分别为各自组的42.3%、31.5%、38.1%。儿童及少年特重度过敏患者中,男性患者所占比例明显高于女性(P=0.04,P=0.01)。结论户尘螨及粉尘螨过敏常同时存在,且过敏严重程度相当。尘螨过敏原敏感程度与年龄及性别明确相关。     

青霉素类过敏病人血清中特异性IgE与HLA-DRB基因多态性

目的 :探讨青霉素特异性IgE抗体与HLA DRB基因多态性的关系。方法 :用放射过敏原吸附试验(RAST)测定 3 97例过敏病人和 1 0 1例正常人血清中8种抗原决定簇 (BPO PLL、PVO PLL、APO PLL、AXO PLL、BPA PLL、PVA PLL、APA PLL、AXA PLL)特异性IgE抗体 ,采用序列特异性引物聚合酶链反应 (PCR SSP)的方法检测了 1 1 3例过敏病人和 87例正常人HLA DRB基因型。结果 :与对照组相比 ,BPO抗体阳性组中的DR1 6基因频率和PVO抗体阳性组中的DR1 4.1基因频率均显著降低 (0比 8.62 % ,P <0 .0 1 ;1 .5 6%比 9.77% ,P <…     

螨类过敏与支气管哮喘

过敏性哮喘患者,多数对屋尘过敏,尘螨是其中重要的过敏原。本文从以下几方面进行研究:①用放射性过敏原吸附剂试验(RAST)和酶联免疫吸附剂试验(ELISA)分别观察到哮喘患者血清中存在着抗粉尘螨的特异性IgE,其阳性率分别为67.9％(RAST 81例)及71％(ELISA 100例)而正常人仅为5％(RAST 40例)及0％(ELISA 31例)。②用螨浸液从豚鼠制备了哮喘的实验动物模型。③从100例过敏性哮喘患者和40例正常人的皮试中,观察到哮喘患者螨浸液皮试的阳性率为75％,明显高于正常人的7.5％。此外,还成功地将哮喘患者的血清被动转移至正常人和猴皮肤,导致阳性反应。这些都清楚地阐明尘螨是一种很强的过敏原,螨类过敏是国内哮喘发病的一个重要病原。     

Validation of a two-color flow cytometric assay detecting in vitro basophil activation for the diagnosis of IgE-mediated natural rubber latex allergy

BACKGROUND: IgE-dependent triggering of basophils not only elicits the release of different mediators but also the up-regulation of certain markers, e.g. CD63, which can be detected by flow cytometry. We intended to investigate if flow cytometric analysis of basophil activation could be a valuable tool in the diagnosis of latex allergy, and to evaluate if the basophil activation test (BAT) could be helpful in determining the clinical significance of a positive latex IgE in individuals with negative history and negative latex skin test. Additionally we aimed to determine the role of cross-reactive carbohydrate determinants (CCDs) in causing positive latex IgE without apparent clinical significance. METHODS: Twelve healthy controls without a history of latex hypersensitivity with a negative latex IgE and skin test (group 1), 24 individuals without a history of latex hypersensitivity with a negative latex IgE and skin test but with other inhalant allergies (group 2), and 29 latex allergic patients with a compelling history of latex allergy with a positive latex IgE and prick test (group 3) were enrolled. The diagnostic performances of the BAT were further evaluated in 13 individuals with a history of latex allergy but with negative specific IgE and/or skin test (group 4). Twenty-four individuals with positive latex IgE without apparent clinical relevance, i.e. without history of latex hypersensitivity and negative latex skin tests, were also analyzed (group 5). The putative role of CCDs causing positive latex IgE results without apparent clinical significance was evaluated by quantification of IgE for bromelain. RESULTS: According, to the receiver operating characteristics(ROC)-generated threshold value of 17% between latex allergic patients and the pooled group of nonlatex allergic individuals, the sensitivity and specificity of the basophil activation test was 93.1% and 91.7%, respectively. In healthy controls, allergic patients without latex hypersensitivity and latex allergic patients the number of positive BATs was 0/12, 3/24 and 27/29, respectively. In the individuals with an evocative history of latex allergy but with negative latex IgE and/or skin test the BAT was positive in all 13 cases. Twenty of 24 individuals without apparent latex allergy but with positive latex IgE had a negative BAT. IgE for bromelain was positive in 1/19 sera from group 2, 1/24 sera from group 3, none of the 8 sera from group 4, but in 16/18 sera from group 5, respectively. CONCLUSION: Flow cytometric analysis of activated basophils seems a highly sensitive and specific tool for diagnosing latex allergy. In addition, the technique might help to determine the clinical relevance of positive IgE quantification in the absence of overt latex allergy. CCDs of natural rubber latex allergens were confirmed to mimic latex sensitization.     

Sensitization to Dermatophagoides siboney, Blomia tropicalis, and other domestic mites in asthmatic patients

Mite species adapted to warm, humid climates are commonly found in house dust in the tropics. In Cuba, Dermatophagoides pteronyssinus, D. siboney , and Blomia tropicalis are the most common and abundant mite species in house dust. To investigate the pattern of Sensitization of Cuban asthmatic patients to common mite species, we skin-prick-tested (SPT) 148 patients with a clinical history of asthma and possible mite allergy, and determined specific IgE antibodies against mite allergens ( D. pteronyssinus, D. farinae, D. siboney, B. tropicalis, Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae , and Glycyphagus domesticus ). The prevalence of positive SPT was high to D. siboney (88%), D. pteronyssinus (87%), A. siro (85%), B. tropicalis (85%), and D. farinae (83%). The largest skin reactions were obtained with D. siboney and B. tropicalis extracts. The skin test response to the D. siboney extract correlated to those of D. farinae, D. pteronyssinus, B. tropicalis , and A. siro. The highest IgE levels were found to Dermatophagoides species and B. tropicalis. IgE to D. siboney and B. tropicalis were found in 97% and 96% of the patients, respectively. The prevalence of specific IgE to the other mites studied varied from 46 to 65%. D. siboney and B. tropicalis are important sensitizers among asthmatic patients in Cuba.     

The prevalence of latex allergy in children seen in a university hospital allergy clinic

Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms, ranging from rhinoconjunctivitis to severe anaphylaxis, in both adults and children. An association between allergy to latex and allergy to various fruits has been reported. This study investigated the prevalence and clinical significance of latex sensitization in children seen in a university hospital allergy clinic. A total of 453 consecutive children were screened in a 7-month period. A detailed clinical history with particular attention to the past surgical history and the eventual presence of latex- or food-induced allergic symptoms was obtained. Skin prick tests (SPT) for the more important inhalant allergens and foods were performed on all children. In patients with positive latex SPT, latex challenge and additional SPT for some fresh foods (avocado, pineapple, apricot, grape, banana, pear, apple, orange, almond, and chestnut) were also performed. RAST for the same food antigens, as well as patch test with latex and a standard battery of contact allergens, was also done. Of 326 atopic children, 10 (3%) presented positive skin test to latex, but only five (1.5%) also had a positive clinical history to latex exposure. Latex challenge was positive in 3/9 positive-latex-SPT children. None of the nonatopic children had positive skin test to latex or symptoms to latex exposure. A history of previous surgery was found in 5/10 positive-latex-SPT children, in 63/316 negative-latex-SPT atopic children (P<0.05), and in 23/127 nonatopic children. RAST to latex was positive in 5/10 positive-latex-SPT children. Associated fruit-specific IgE (SPT and/or RAST) were found in all latex-symptomatic children and in 2/5 latex-asymptomatic children. Apple, kiwi, and chestnut were the most common SPT-positive foods. Only one patient with clinical allergy to latex and positive skin tests to fruits had a history of clinical symptoms after ingestion of kiwi and orange. The natural history of the positive-latex-SPT children without clinical reactions to latex exposure and the clinical significance of the association of latex and fruit sensitivity require further studies.     

A cross‐sectional study on the prevalence of food allergy to eggplant (Solanum melongena L.) reveals female predominance

Background Only a few case reports of allergy to eggplant (Solanum melongena) have been reported. A relatively large number of individuals appear to experience food‐related symptoms to eggplant in India. Objective The major aims of this study are to assess the prevalence of food allergy to eggplant and analyse the age and gender distribution. Methods Seven hundred and forty‐one subjects (age range: 5–60 years) randomly selected from rural and urban areas of Mysore city were analysed for the prevalence of eggplant allergy based on case history, skin prick test (SPT) with eggplant extracts and allergen‐specific IgE. The age and gender distribution for the prevalence of eggplant allergy and its association with other atopic conditions were assessed. Results Sixty‐eight (9.2%) subjects reported adverse reactions to ingestion of eggplant, of which 32 (4.3%) subjects had positive history/positive SPT and 36 (4.9%) had positive history/negative SPT. Sixteen (2.2%) subjects had negative history/positive SPT. Ten subjects (1.4%) experienced allergic symptoms in <2 h. Sensitization to eggplant by SPT was more in atopic (16.7%) compared with non‐atopic subjects (3.8%). All the SPT‐positive subjects (n=48) underwent evaluation for eggplant allergen‐specific IgE, which was detected in 6 subjects (0.8%). Majority of the subjects sensitized to eggplant were in the age groups 16–45 years, and females were twice as likely to be sensitized as males. Female predominance (4 : 1) is more in the 16–30 year group. Conclusions Many subjects experience adverse reactions to the ingestion of eggplant, possibly due to the pharmacologic action of histamine and other non‐protein components, rather than to specific protein allergen(s). The prevalence of IgE‐mediated eggplant allergy is estimated at ～0.8%, with higher rates of sensitization in females.     

Clinical research of specific IgE and IgG4 antibody in allergic children. Examination by multiple factor analysis-type II. (objective variables: specific IgE antibodies and IgG4 antibodies to food allergen)

We examined the influence power of 16 explanation variables to specific IgE antibody and IgG4 antibody to egg white cow's milk, and soybean in 150 asthmatic children by Multiple Factor Analysis-Type II 16 examination variables; 1) sex, 2) age, 3) onset age, 4) IgE RIST, 5) eosinophile count, 6) IgE RAST score to house dust, 7) IgE RAST score to Dermatophagoids farinae, 8) atopic dermatitis, 9) allergic rhinitis, 10) family history of allergy, 11) positive counts of food allergen: IgG4, 12) specific IgG4 antibody to cow's milk, 13) specific IgG4 antibody to soybean, 14) exercise induced asthma, 15) severity of asthma. The following results were obtained. 1) To introduce range relative ratio, we were able to use all 16 explanation variables on the occation of calculating by Multiple Factor Analysis-Type II. 2) 4 explanation variables (specific IgG4 antibody to soybean, IgE RIST, IgE RAST score to Dermatophgoides farinae, age) had the stronger influence power to 8 objective variables than the other explanation variables. 3) Only 2 explanation variables (specific IgE antibody to soybean, family history of allergy) had the stronger influence power to 8 objective variables than the other explanation variables.     

Type I latex allergy in health care workers with latex-induced contact urticaria syndrome: a follow-up study

BACKGROUND: Latex allergy is an important occupational health issue among health care workers (HCWs). Secondary prevention in sensitized/allergic individuals involves avoiding exposure to NRL products. AIMS OF THE STUDY: The aim of this follow-up study is to determine the long-term health consequences in HCWs with type I latex allergy with latex-related contact urticaria syndrome, of providing appropriate information and practical avoidance education. METHODS: Seventeen HCWs with latex-induced contact urticaria syndrome, as ascertained by the glove use test, were investigated. Initial and follow-up visits included: a detailed questionnaire, skin prick test (SPT) with glove eluates and with commercial latex extract, SPT with common inhalant and food extracts, serum specific immunoglobulin (Ig)E to latex and some foods and the glove use test. RESULTS: On re-examination, 11 (64.7%) subjects showed positive SPTs to extemporaneous extract and 10 (58.8%) patients showed a positive SPT to commercial extract. Of the nine patients with detectable levels of serum latex specific IgE at first evaluation, four (44.4%) became negative and four were assigned to at least one class lower. Only one (11.1%) employee had higher radioallergosorbent test values than those at the latex allergy diagnosis. At follow-up, the 17 individuals had positive latex challenge results, although the duration of exposure causing a reaction increased. CONCLUSION: Our study shows that preventive measures are sufficient to induce a reduction of sensitization. Continued avoidance is needed to prevent re-sensitization or adverse reactions on re-exposure.     

Risk factors for latex allergy in patients with spina bifida and latex sensitization

BACKGROUND: Some subjects with spina bifida (SB) and latex sensitization (cutaneous and/or serum IgE) can have clinical reactions, while others may have no symptoms after the exposure to latex products. OBJECTIVE: This study was carried out to determine the risk factors associated with latex allergy in patients affected with SB and latex sensitization. METHODS: Fifty-nine consecutive subjects affected with SB, besides answering a questionnaire, underwent a skin-prick test (SPT) to latex and the determination of the specific serum IgE (RAST CAP) to latex. The total serum IgE concentration was determined and SPT to common aero- and food-allergens, skin tests (prick + prick) with fresh foods (kiwi, pear, orange, pineapple, tomato, banana) and RAST CAP to the same foods tested by the prick + prick technique, were also performed. RESULTS: Fifteen out of the 59 subjects (25%) were sensitized to latex according to the presence of IgE to latex detected by SPT (nine patients) and/or RAST CAP (13 patients). Five out of the 15 sensitized patients (33%) suffered from clinical reactions to latex (urticaria, conjunctivitis, angioedema, rhinitis, bronchial asthma) while they were using latex gloves and while inflating latex balloons. In the 15 sensitized patients, the presence of specific latex seric IgE > 3.5 kU/L (>/= class 3), a positive latex SPT, an elevated total serum IgE, and a positive prick + prick and/or a positive RAST CAP to foods, were significant (P < 0.05) risk factors associated with latex symptoms. The other factors tested (age, gender, months of intermittent bladder catheterization, surgical procedures, SPT reactivity and clinical reactions to aero-allergens and food-allergens, skin tests for fresh foods, positive RAST CAP to foods) were not significantly different in symptomatic and asymptomatic patients. CONCLUSION: Significant risk factors for symptoms to latex in patients with SB and latex sensitization were a presence of specific IgE to latex > 3.5 kU/L, a more frequent positive latex SPT, elevated total IgE, and one or more positive prick + prick and/or RAST CAP to fresh foods.     

The importance of nasal provocation test in the diagnosis of natural rubber latex allergy

Background:  Most studies regarding natural rubber latex (NRL) allergy have concentrated on the prevalance using skin prick test (SPT) and specific IgE assay. The objective of this study is to examine the target organ (skin, nasal mucosa) responses in patients with positive SPT to NRL using the nasal provacation test (NPT) and glove use test (GUT).
Methods:  Four thousand four hundred and twenty patients presented to our polyclinic between July 2003 and January 2007 were evaluated. One thousand six hundred and ninety-nine patients had positive SPT to one or more allergens (NRL and other inhaler allergens). Twenty-nine patients with positive SPT to NRL comprised the NRL sensitive group (group 1). Thirty-five randomized patients with positive SPT to an inhaler allergen other than NRL and negative NRL-specific IgE comprised atopic control group (group 2). Thirty healthy individuals who had no allergic diseases and had negative SPT and NRL-specific IgE comprised the healthy control group (group 3).
Results:  The lowest NRL allergen concentration leading to NPT positiveness was 0.05 μg/mL. NPT was negative in groups 2 and 3. NPT was found to have a sensitivity of 96%, specificity of 100%, negative predictive value of 98% and positive predictive value of 100%. GUT was found to have a sensitivity of 81%, specificity of 90%, negative predictive value of 75% and positive predictive value of 93%.
Conclusions:  Nasal provocation test was successfully used for the first time in the diagnosis of NRL allergy. NPT is a more sensitive method as compared to GUT.     

Prevalence of latex sensitization in healthy blood donors in Izmir, Turkey

Although latex is a common allergen, the prevalence of natural rubber latex allergy in the general population in Turkey is unknown. The aim of this study was to assess the prevalence of sensitization to natural rubber latex in a population of healthy blood donors. As skin prick testing of a sample of the general population was not feasible, the subgroup of adult healthy blood donors was chosen instead. Skin testing with commercially available reagents (Stallergenes) was performed on 952 volunteers attending the Blood Centre of the Social Security Hospital in Izmir, Turkey in 2001. The study population completed a questionnaire involving history of personal allergy and symptoms. In 20 blood donors (2.1%) the latex skin prick test (SPT) was positive. No relationship by age or gender was found. There was no relationship between previous allergic symptoms and SPT positivitiy to latex except for the systemic reaction related to any allergen (deep wheezing or any difficulty breathing, nausea, vomiting, palpitations, faintness or edema). The prevalence of SPT positivity to natural rubber latex was 2.1% in a Turkish blood donor group, which can be related to the latex sensitivity within the general Turkish population.     

Assessment of latex allergy in a healthcare population: are the available tests valid?

BACKGROUND: Latex allergy can cause serious, preventable work-related health problems in healthcare workers who are a high risk group for this form of allergy. Type I hypersensitivity can produce life-threatening systemic effects, and involves an allergen-specific immunoglobulin (IgE) response to proteins found in latex. The estimated prevalence of latex 'allergy' in healthcare workers varies widely (2.8% - 18%), and studies do not always distinguish between those who are positive in an assay for latex-specific IgE and those with clinical allergy. OBJECTIVE: To assess the performance of four in-vitro methods and three skin testing methods for detecting latex-specific IgE in a group of UK healthcare workers. Test results were compared with reported clinical symptoms defined by questionnaire. METHODS: Skin prick testing was carried out on volunteers using three reagents: (a) stallergenes commercial latex extract (Cedex, France); (b) an in-house latex glove extract; and (c) a fresh glove piece. Specific IgE levels were determined using Pharmacia AutocapTM (Uppsala, Sweden), Pharmacia UnicapTM (Uppsala, Sweden), DPC Immulite(R) (Los Angeles, USA) and Hycor HytecTM (Irvine, California, USA) methods. Each volunteer completed a questionnaire detailing latex exposure and allergic history. RESULTS: In vitro methods for detecting specific IgE to natural rubber latex were positive in 3.6%, to 43.6% of the same population. Skin prick tests positivity varied between 2. 9% and 14.3% with different extracts. From the subjects tested 9.1% reported symptoms which could be consistent with type I allergy, although none had been given a pre-existing diagnosis of latex allergy, and 43.6% of volunteers reported symptoms consistent with type IV hypersensitivity or irritant dermatitis. Contingency tables and chi-squared analysis revealed no correlation between most methods. No correlation was shown between symptoms consistent with type I allergy and any in vitro or skin testing method for latex-specific IgE. CONCLUSIONS: A wide variation between testing procedures was found, and no method could be correlated with reported symptoms of type I allergy. At least one in vitro specific IgE assay produced a high percentage of positive results at variance with the clinical symptoms in volunteers. A clinical history is essential in establishing type I hypersensitivity to latex and test results should not be used in isolation. The incidence of clinical sensitization may be seriously over-estimated if only laboratory parameters are used.