Abstract

DIAS, José Geraldo et al. Comparative study of survey methods for atopy in patients with rhinitis (ImmunoCAP® Rapid versus Phadiatop^® and skin prick tests). Rev Port Imunoalergologia [online]. 2013, vol.21, n.1, pp.41-47. ISSN 0871-9721.

Background: About 75% of rhinitis patients suffer from allergies. Respiratory allergy diagnosis allows therapeutic optimization. ImmunoCAP^® Rapid is an in vitro assay for qualitative determination of specific IgE in human whole blood. Aim: To evaluate sensitivity, specificity, negative predictive value and positive predictive value of ImmunoCAP^® Rapid in the identification of atopy in patients with rhinitis, comparing to Phadiatop^®, assuming skin prick tests (SPT) as gold standard; to evaluate correlation between SPT and ImmunoCAP^® Rapid results for each aeroallergen. Methods: Cross-sectional, randomized study with 40 adult patients with rhinitis observed in the Immunoallergology outpatient unit, 30 of them with positive SPT to at least one aeroallergen. All patients underwent Phadiatop®, ImmunoCAP^® Rapid and SPT for Dermatophagoides pteronyssinus, dog and cat dander, Blatella germanica, Alternaria alternata, Phleum pratense, Parietaria judaica, Olea europaea, Artemisia vulgaris and Betula verrucosa. SPT ≥ 3mm than negative control were considered positive. Results: Average age of 34 ± 11 years, 53% female. Sensitivity and negative predictive value of ImmunoCAP^® Rapid in the identification of atopy: 90% and 77% (Phadiatop^®: 93% and 83%). Specificity and positive predictive value: 100% in both methods. Analysing allergens individually, ImmunoCAP^® Rapid and SPT disclosed a mean agreement of 88.8% ± 7.4%. ImmunoCAP^® Rapid failed to identify at least one sensitization in 25 of 30 patients, totalizing 40 negative results with positive SPT. Conclusion: Considering its sensitivity and negative predictive value, ImmunoCAP^® Rapid might be considered an acceptable method to investigate atopy in patients with rhinitis. However, the analysis of its performance for each aeroallergen revealed, comparatively to SPT, that ImmunoCAP^® Rapid does not allow to identify all clinically relevant sensitizations in a considerable percentage of patients.

Keywords : Atopy; ImmunoCAP^® Rapid; negative predictive value; positive predictive value; sensitivity; specificity.

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