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New Research - June 2009
Reactions to immediate hypersensitivity skin tests; reponse to epinephrine injection
The object of this study was to look at the incidence of systemic reactions to allergy skin tests (prick and intradermal). It was a prospective design, and it looked at 1,456 subjects. Fifty-two of these (3.6%) experienced a systemic reaction to skin testing. Reactions included itching eyes, nose, or pharynx, cough, a sensation of difficulty swallowing, nasal congestion, runny nose, chest tightness or shortness of breath, generalized itching, sneezing, wheezing and hives. Every patient who experienced a reaction received intramuscular epinephrine (deltoid) at the time of the reaction. In addition, 48 (92%) received oral prednisone at the time of the reaction. Nine (17%) received oral prednisone to take 6 to 8 hours later. Fifty (96%) received an oral antihistamine, and six (12%) were given a nebulized beta-agonist.
The authors concluded that the incidence of systemic reaction to skin testing in their patient population was 3.6% (0.4% for prick tests, and 3.2% for intradermal tests). All responded to epinephrine administered intramuscularly in the deltoid. They hypothesized that the immediate administration of epinephrine prevented more serious reactions and perhaps biphasic reactions.
Reference
Bagg A, et al. Reactions to prick and intradermal skin tests. Annals of Allergy, Asthma, and Immunology 2009; 102(5):400-402.
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