A negative prick test is usually interpreted as "allergy-free," despite suspected respiratory symptoms. However, it may be more reasonable to test the patient for less frequent inhaled allergens according to his or her local, professional, and amateur history.
There are several reasons why one "Rare" allergens it is, yes. causes allergy in less than 3% of cases. One of them is weak sensitizing potential, such as spruce, fir and larch. The risk of low exposure also plays a role, for example, with exotic plants in greenhouses or other animals. Many new, initially rare allergens can mutate over time, but quite often, just think of a swamp swamp, University Doc writes. Felix Wantke and University Lecturer Wolfgang Hemmer of the Floridsdorf Vienna Allergy Center. For some rare pollen allergens – u.a. Goosefoot, jar, nettle, strawberry and cypress – now there are substances to test. The same applies to certain mites and molds.
To find out about rare allergies, two colleagues recommend considering the following seven points:
- You should think with appropriate symptoms despite rare tests on rare allergens.
- Environmental and work allergens may also be rare.
- The rarity of the allergen is relative depending on the geographical location.
- The diagnosis of a rare allergen cannot always be made by standard panels or commercially available test panels.
- Serology is unreliable.
- The diagnostic strategy is called: History – History – History! If possible, perform a prick-a-bite test and possibly some provocation.
- If in doubt, the patient should be presented to an allergy or occupational health clinic.
How relevant rare inhalant allergens can be in a particular case is demonstrated by Dr. Med. Wantke and Dr. Hemmer on some case studies:
Lots of nettle in the garden
The 16-year-old comes in 2008 for the first time, then almost every year between May and August Rhinoconjunctivitis and cough in Allergieambulanz. However, prick tests are always negative. Only when the patient was plentiful in 2013 nettle growth mentioned in her garden, she did a targeted prick test and proper serology. Tests confirm nettle allergy. Specific immunotherapy for two and a half years significantly improves symptoms.
Schabenzucht for tarantulas
Since mid-2010, the 34-year-old has been increasingly complaining about one stuffy nose and rhinitis, She keeps scorpions and tarantulas at home, and grows their food – grasshoppers and cockroaches. The routine test for cockroach IgE allergy is negative. The man develops more and more symptoms and is even 2011 due Bronchial asthma treat hospital. A little later, a prick-to-prick test is performed, which gives a very positive result for the cultured patient Madagascar Riesenfauchschabe the results. On the other hand, itch serology is only weakly positive.
Millet soup in the spa
Even after the first consumption of millet, a severe anaphylactic reaction is possible. For an 88-year-old, two tablespoons of ground soup at a spa hotel was enough to house one Shortness of breath laryngeal edema trigger. Bird keepers are known to be one inhalation sensitivity to feed millet can come. In fact, the old lady was holding the slippers more than 40 years ago.
Dangerous sauna floors
Firs, beech, oak – no problem. However, the young carpenter handles it abaci wood She responds more often and harder to picture frames or wooden sauna floors Rhinoconjunctivitis, stuffy nose and cough, The prick-to-prick test is particularly positive for wood dust. Abachi's major tree allergen, Trip s 1, shows homology with latex Hev b 6, latex allergy cannot be detected in the patient, however, two colleagues reported.
Papain in a meat softener
Two employees of the spice processing factory are professionally confronting each other meat softener containing papain (Mürbsalz) exposed. In the days of papain filling, which happens about six times a year, they suffer more and more Rhinitis, conjunctivitis, cough and dyspnea – obviously the consequences of an allergy, as both respond to a prick test on Papain, serology is also positive. Switching women to other machines or wearing respiratory masks can significantly reduce symptoms.
papain it is made from the dry milky juice of immature papaya and is commonly used for
- Meat softener
- Beer clarification
- Detergents, toothpaste, denture and contact lens cleaning products
- digestive aids
Source: Wantke F, W. Pneumo Inhibitor 2019; 4: 10-15