Abstract
Introduction: The modern man is exposed to a large variety of allergens compared to his predecessors. Intradermal antigen testing provides a clinically useful method to understand the common allergens among patients. Identification of culprit allergens in patients with nasobronchial allergy shall aid in allergen avoidance and specific treatment.
Aim: To study the pattern of allergen sensitivity in patients with nasobronchial allergy.
Materials and Methods: In this retrospective study, the pattern of antigen sensitivity was analysed in 2048 patients with nasobronchial allergy who were subjected to intradermal antigen testing over a period of six years. A total of 34 antigens were tested which consisted of 16 pollen antigens, 8 dust antigens, 6 insect antigens and 4 fungal antigens.
Results: Out of 2048 patients tested, 1170 showed positive reaction. 81% of the patients had asthma, 79.6% had rhinitis, 60.6% had both, 21% had cough and 6.26% had urticaria. Among those showing positive reaction, 75% had a definite history of allergy. Maximum number of positive reaction was seen with insect antigens belonging to house dust mite (27.25%) followed by cockroach antigen. The major dust antigen was cotton dust(25.12%). Among pollen antigens, Cynodon dactylis showed maximum number of positive reaction (12.99%). Aspergillus flavus and niger were the most common fungal antigens0020(both 4.44%).
Conclusion: The commonest culprit allergens identified in this study was house dust mite followed by other insect antigens. The pattern of sensitivity may vary in different regions owing to geographical and environmental influences.
Keywords: Intradermal test, Allergens, House dust mite.
References
- Singh AB, Mathur C. An aerobiological perspective in allergy and asthma. Asia Pac Allergy. 2012;2(3):210–22.
- Woodruff PG, Bhakta NR, Fahy JV. Asthma: pathogenesis and phenotypes. In: Broaddus VC, Mason RJ, Ernest JD, King TE, Lazarus SC, Murray JF, Nadel JA, Slutsky AS, Gotway MB. Murray and Nadel’s textbook of respiratory medicine. In: 6th ed. India: Elsivier; 2016: 713–30.
- Shivpuri DN. Comparative evaluation of the sensitivity of common methods of diagnostic antigen tests in patients with respiratory allergy. Indian J Chest Dis. 1962;4:102–8.
- Chogtu B, Magaji N, Magazine R, Acharya PR. Pattern of Allergen Sensitivity among Patients with Bronchial Asthma and/or Allergic Rhinosinusitis in a Tertiary Care Centre of Southern India. J Clin Diagn Res. 2017;11(8):OC01-OC04.
- Patel A, Choudhary S. Prevalence of Allergen Sensitivity in Nasobronchial Allergy in Gujarat, India. Natl J Med Res. 2012;2:431–4.
- Prasad R, Verma SK, Dua R, Kant S, Kushwaha RA., Agarwal SP. A study of skin sensitivity to various allergens by skin prick test in patients of nasobronchial allergy. Lung India Off Organ Indian Chest Soc. 2009;26(3):70–3.
- Kumar R, Sharan N, Kumar M, Bisht I, Gaur S. Pattern of skin sensitivity to various aeroallergens in patients of bronchial asthma and/or allergic rhinitis in India. Indian J Allergy Asthma Immunol. 2012: 1;26.
- Agrawal RL, Chandra A, Jain S, Agrawal G, Snehlata. Identification of common allergens by skin prick test associated with united airway disease in Allahabad, Uttar Pradesh, India. Indian J Allergy Asthma Immunol. 2008;22(1):7-13.
- Balaban J, Bijelic R, Milicevic S. Hypersensitivity to aeroallergens in patients with nasobronchial allergy. Med Arch Sarajevo Bosnia Herzeg. 2014;68(2):86–9.
- Milián E, Díaz AM. Allergy to house dust mites and asthma. P R Health Sci J. 2004;23(1):47–57.
- Mishra DV, Mahmood T, Mishra JK. Identification of common allergens for united airway disease by skin prick test. Indian J Allergy Asthma Immunol. 2016;30(2):76-9.
- Sarinho ECS, Mariano J, Sarinho SW, Medeiros D, Rizzo JA, Almerinda R S, et al. Sensitisation to aeroallergens among asthmatic and non-asthmatic adolescents living in a poor region in the Northeast of Brazil. Allergol Immunopathol (Madr). 2009;37(5):239–43.
- Sam CK, Soon SC, Liam CK, Padmaja K, Cheng HM. An investigation of aeroallergens affecting urban Malaysian asthmatics. Asian Pac J Allergy Immunol. 1998 Mar;16(1):17–20.
- Jerath VP, Sood M, Nischal R. Prevalance of skin reactivity to fungal antigens in patients of nasobronchial allergy of Jalandhar and neighbouring area in Punjab. Indian J Allergy Asthma Immunol. 2012;26(2):73-6.
- Verma KS, Shrivastava P, Dey M. Skin prick test to common air borne fungi on poultry workers.Indian J Allergy Asthma Immunol. 2011;25(2):79-83.
- Carlsten C, Ferguson A, Dimich-Ward H, Chan H, DyBuncio A, Rousseau R, et al. Association between endotoxin and mite allergen exposure with asthma and specific sensitization at age 7 in high-risk children. Pediatr Allergy Immunol Off Publ Eur Soc Pediatr Allergy Immunol. 2011 May;22(3): 320–6.
- Ege MJ, Mayer M, Normand A-C, Genuneit J, Cookson WOCM, Braun-Fahrländer C, et al. Exposure to environmental microorg-anisms and childhood asthma. N Engl J Med. 2011 Feb 24;364(8):701–9.
Corresponding Author
Parvathy Santhosh
Senior Resident, Department of Dermatology,
Government Medical College, Kozhikode, Kerala
Phone number: 9847153539, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.105
