Conventional allergy tests

Article Abstract:

Investigation of allergy in children focuses on three problems: the symptoms associated with allergy exposure; the relation between removal of allergen and improvement of the condition; and identification of the allergen that worsens the condition. The usefulness of allergy tests in resolving these problems is assessed. In the skin prick test, the allergen is introduced into the skin, and the development of a weal and flare reaction indicates the immune protein (antibody) directed against the allergen; antibody is primarily immunoglobulin E (IgE). Some problems with skin prick tests include an inconsistent definition for a positive reaction; the occurrence of positive reactions in patients without symptoms; the persistence of positive reactions when a child has outgrown an allergy; the occurrence of negative tests in allergic patients; the inability to detect allergies not mediated by IgE (such as reactions to cows' milk protein); varying strengths of allergen extracts; and errors in method. Intradermal tests are more sensitive than skin prick tests, but may also cause severe allergic reactions and produce more false-positive results. The blood levels of IgE antibody can be measured using the radioallergosorbent (RAST) test, which is less sensitive than skin prick tests, but can be useful in certain cases. Challenge tests may be performed to provoke symptoms by direct delivery of the allergen to a sensitive site such as the lung or the nasal passages. These tests may be administered by inhalation or by ingestion, and the difficulties associated with these approaches are listed. Tests measuring IgE antibody tend to be insensitive, and the best approach is to carefully examine the patient's history. Intolerance to food is often due to immune processes, and skin and RAST tests are not helpful, whereas challenge tests are mainly used as research tools. The most logical approach to investigating food intolerance consists of avoiding the suspected allergen, followed by food challenge. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Testing, Allergy in children, Pediatric allergy, Immunoglobulin E, Food allergy in children, Pediatric food hypersensitivity

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Prevalence of liver disease in cystic fibrosis

Article Abstract:

Cystic fibrosis is an inherited disease in which thick mucus blocks the passageways in the pancreas, intestines and lungs, and impairs the function of these organs. Also, this disease causes a dense and fibrous tissue, similar to scar tissue, to form in organs such as the pancreas and lungs. In the past, the survival rate for patients with this disease was poor and survival beyond childhood was uncommon. In recent years, rates of survival have improved and as a consequence, increasing numbers of cases of liver disease in patients with cystic fibrosis have been reported. Therefore, a study was performed to determine the incidence of liver disease in cystic fibrosis. The medical records of 1,100 patients with cystic fibrosis were reviewed. Four percent of the patients had an abnormally large liver, spleen or both. Liver disease was three times more common in males than in females. It was uncommon in patients under the age of 10, was more common in patients between the ages of 10 and 20, and was less common in those over 20. The mean age at death was 14 years and the most common cause of death was lung failure. Liver disease was a rare cause of death, but the patients who had liver disease were more likely to die earlier. It is concluded that the incidence of liver disease in patients with cystic fibrosis is increasing, is more common in males than females, occurs mainly in patients between the ages of 10 and 20, and is associated with a less favorable outcome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Cystic fibrosis, Liver cirrhosis

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