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Clinical significance of skin test and specific IgE measurement for the prediction of immediate type hypersensitivity reaction to horse antithymocyte globulin

Other Title
항 흉선세포 말혈청글로불린에 대한 즉시형 과민증의 예측에 있어서 피부반응시험과 특이 IgE 항체검사의 임상적 유용성
Authors
이, 현주; 임, 의진; 지, 서영; 강, 석윤; 서, 유진; 조, 재웅; 김, 선신; 이, 수걸; 남, 동호; 박, 해심; 김, 현수; 남, 동기; 김, 효철
Citation
Chʿŏnsik mit alrerugi, 20(6):936-942, 2000
Journal Title
Chʿŏnsik mit alrerugi; Journal of asthma, allergy and clinical immunology; Korean journal of asthma, allergy and clinical immunology; 천식 및 알레르기
ISSN
1226-8739
Abstract
Background: Horse antithymocyte globulin (ATG) is a useful treatment for aplastic anemia and for bone marrow transplantation from HLA-mismatched donors. Mortality due to anaphylactic reaction to horse ATG has been reported. We evaluated the

clinical

significance of skin test and specific IgE measurement for the prediction of immediate type hypersensitivity reaction to horse ATG.

Subjects and methods : The study subjects consisted of 25 patients who received horse ATG. Underlying diseases of the 25 patients included aplastic anemia (n=20), leukemia (n=3), lym- phoma (n=1), and Gaucher's disease (n=1). Skin prick test was

done on

these patients using undiluted ATG solution (Upjohn, USA) with duplication. Specific IgE to ATG was detected by enzyme-linked immunosorbent assay and immunoblot analysis.

Results : Skin prick test was positive in 7 (28%) of 25 patients. None of the patients showing negative skin prick test experienced immediate type hypersensitivity reaction to ATG. All pati- ents showing positive skin prick test received

desensitization

before the administration of a full dose of ATG. However, 3 of 7 patients showing positive skin prick test experienced immediate type hypersensitivity reaction; one of them died of anaphylaxis. Specific IgE measurement using enzyme-linked

immunosorbent

assay was not useful in predicting immediate type hypersen- sitivity reaction to ATG because of nonspecific bindings. Specific IgE measurement using immunoblot analysis was only positive in the one patient who died of anaphylaxis.

Conclusion : Skin prick test was clinically useful in the prediction of immediate type hypersensitivity reaction to horse ATG, but specific IgE measurement was not. Further studies might be needed to develop an in vitro test for the prediction of

immediate type hypersensitivity reaction to horse ATG.
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Journal Papers > School of Medicine / Graduate School of Medicine > Allergy
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