The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Aug 1988
Comparative StudyDiscrepancies between the skin test and IgE antibody assays: study of histamine release, complement activation in vitro, and occurrence of allergen-specific IgG.
Intracutaneous skin tests (STs) and RAST with the common allergens, grass pollen, house dust mite, and cat dander, were performed on 660 adult patients. In 117 patients (18%), we found 140 discordances (7%) in a total number of 1980 ST and RAST combinations. In agreement with studies in the literature, greater than 80% of the discordances consisted of positive skin reactions without detectable allergen-specific IgE antibodies in serum. ⋯ Low total IgG responses precluded false negative RAST results caused by competition of IgG antibodies with IgE antibodies. There were no significant differences in the degree of complement activation in vitro by house-dust extracts between healthy control subjects, nonallergic patients, and patients with unexplained skin reactivity. It is concluded that a high proportion of the positive skin reactions with common inhalant allergens, which are not accompanied by a positive RAST, are probably caused by IgE antibodies that are not detectable in serum with any of the RAST procedures.(ABSTRACT TRUNCATED AT 400 WORDS)