Allergic diagnostic specimens

Allergic diagnostic specimens is highly specific and sensitive method of diagnostics of allergic and infectious diseases in the pathogenesis of which prevails allergic component. Samples based on local or General reactions sensitized organism in response to the introduction of specific allergen.
Of particular importance allergic diagnostic specimens are in the diagnosis of allergic diseases, because the definition of allergen or groups of allergens that caused the state of hypersensitivity, allows you to apply these allergens for giposencibilization of the body - most specific and promising method of treatment of allergic diseases.
In the diagnosis of allergic diseases in the process of collection of anamnesis produce the intended group of allergens that may cause the patient's state of hypersensitivity. With these allergens spend allergic diagnostic specimens without exacerbation of the disease. In parallel with the introduction of the allergen is injected control solutions - solvent allergens and physiological solution.
Apply skin and provocative allergic diagnostic specimens.
Skin tests - the safest and simplest form of allergic diagnostic samples. Depending on a way of introduction of the allergen apply application, scratch and intradermal test.
Application samples of applied with sensitivity to simple chemicals (benzene, gasoline and other), certain medicines (iodine, novocaine and others) in patients with contact dermatitis.
On the intact skin of the forearm, back or abdomen impose a piece of cheesecloth moistened with a solution of an allergen (concentration, does not cause skin irritation in healthy people), and stick with the adhesive plaster for 20 minutes. The result is appreciated after 20 minutes, 12 and 24 hours after the application of the allergen. The appearance of the skin at the site of contact with an allergen hyperemia and edema indicates the presence of hypersensitivity to the allergen.
Skarifikih samples used for high sensitivity to pollen, household and epidermal allergens in patients with allergic rhinitis, bronchial asthma, allergic rhinitis, urticaria and angioedema. Skin Palmar side of the forearm put drops of allergen and control solutions. Separate for each allergen by scarificator spend every ounce of parallel scratches. After 20 minutes and 24 hours evaluate samples. The development of edema in the area of scarification indicates a positive reaction.
Intradermal tests applied with sensitivity to bacterial and fungal allergens in patients with bronchial asthma, chronic recurrent urticaria and infectious diseases. These samples are 100 times more sensitive than scratch, but less specific and give more complications.
Tuberculin syringe intradermally injected from 0.01 to 0.1 ml of serum. With the development urticarnae blister in 15 to 20 minutes after administration - positive reaction immediate type. Appearance in the place of the injection zone hyperemia with infiltration in 24-48 hours. indicates a positive reaction of the delayed type.
Some allergens (penicillin and other antibiotics) in the formulation of the sample in patients with a heightened sensitivity to it can lead to serious complications (shock) when conducting scratch and especially intradermal tests. To determine the sensitivity to these allergens is better to use the reaction of passive transfer of hypersensitivity to Prausnitz - Costner. In a patient with Allergy to antibiotics receive a serum containing antibodies. Passively sencibilisiruet skin healthy person, introducing him intradermally serum of the patient. After 24 hours in the place of administration of the serum is injected allergen. Redness of the skin healthy person is indicative of the patient's antibodies specific to the investigated allergen.
In the presence of hypersensitivity delayed-type reaction passive transfer carried out with suspension of lymphocytes of a patient.
Provocative tests is applied in cases where the data of allergro-ronmental history does not correspond to the results of skin tests. Provocative samples from the most specific to the diagnosis of allergic diseases. Apply nasal, conjunctival, inhalation and other provocative tests.
Nasal test used in the diagnosis of allergic rhinitis. Pipette buried in both halves of the nose 2-3 drops of the control of liquid. If no reaction begin the study with increasing concentrations of the allergen. When the obstruction of nasal breathing, sneezing, rhinorrhea, a sample is positive.
Kongungualno test used in the diagnosis of allergic rhinitis with symptoms of conjunctivitis. After a preliminary test with control solution the allergen buried a pipette in the lower kongungualny bag. Redness, watery eyes and itchy eyelids - signs of positive reactions.
Inhalation test used in the diagnosis of bronchial asthma. The solution of allergen give to the patient with the help of the aerosol dispenser. In case of positive test lung capacity is reduced by 10%, develops bronchospasm, which kupeeroout bronholitikami. When using provocative tests taking into account the late response.
Cold test is used in the diagnosis of chronic recurrent urticaria. A piece of ice is fixed on the skin of the forearm for 3 minutes with the help of bandages. At a positive take 10 minutes after removing ice is formed on the skin urticarnae blister.
Heat the sample used in the diagnosis of urticaria. Test tube with hot water (temperature 40 - 42 deg) is placed at 10 minutes on the skin Volar surface of the forearm. Positive reaction is characterized by the formation at the site of contact urticarnae blister.
Allergic diagnostic specimens is also used in the diagnosis of certain infectious and parasitic diseases, accompanied allergic sensitization of the body. In the diagnosis of tuberculosis (see) apply skarifikih samples Pirke and intradermal the Mantoux test. An allergen is used cultivation of dry cleaned of tuberculin. In the diagnosis of brucellosis (see) apply intradermal test Byrne. The allergen is the solution of Brucella that contains antigenic set three different pathogens of brucellosis. In the diagnosis of hydatid (see) is used inside-skin test of Casoni. The allergen is an extract from the content of the bubble Echinococcus. In the diagnosis of tularemia (see) apply intracutaneous test with tulainkom - killed by heating a suspension of bacteria. When Troubleshooting dysentery (see) using a test with dizenterina Tsuverkalov.


Allergic diagnostic tests diagnostic reactions, revealing a state of heightened sensitivity to the relevant allergens.
Sensitized the body responds to the introduction of the allergen unusual reaction of a local or General nature, the extent of which is determined by the species and individual properties of the organism, peculiarities of allergen and ways of its introduction (see Allergy, Anaphylaxis). Allergic condition occurs when the number of infectious diseases (tuberculosis, brucellosis, pneumococcal pneumonia, SAP, toxoplasmosis and other), however, the practical application of allergic diagnostic specimens received at a limited number of diseases. Diagnostic value of A. D. p. determined by their specificity, sensitivity and safety for human or animal. Allergic condition occurs some time after the onset of infection, what to consider when setting A. D. p. Diagnostic value of A. D. p. is that with their help it is possible to detect atypical and chronic cases, when the diagnosis on clinical microbiological data difficult. As allergic condition of the body is preserved for a long period after the disease, A. D. p. can also be used for the production of retrospective diagnosis.
The widest application A. D. p. received in tuberculosis. An allergen is applied faction Mycobacterium tuberculosis, called tuberculin (see). After subcutaneous injection of tuberculin there may be a common response (a sharp increase of temperature), and possible activation of TB infection, so subcutaneous method not found application in medical practice. The distribution has not received well as oftalmologia Calmette - Wolff-Eisner, consisting in application of 1 % solution of tuberculin on the conjunctiva of the eye. Both of these methods are used in veterinary medicine. In medical practice widely used skin test with tuberculin reaction Pirke and intradermal Mantoux test.
In response Pirke skin middle third flexor surface of the forearm put a drop of undiluted tuberculin Koch, and several below - a drop of control solution (saline solution with relevant tuberculin content of phenol). Then in the location of the drops skureviciaus skin for 5 mm, without affecting the blood vessels. After absorption of tuberculin excess of it remove the gauze. The intensity of the reaction is measured in 48-72 hour. largest papules, which emerged at the place of application of tuberculin (printing. table, Fig. 2). Positive reaction Pirke indicates contamination of the organism with Mycobacterium tuberculosis. In early childhood it reflects not only the presence of the pathogen, but also on clinical disease. The relatively low sensitivity reactions Pirke in case of negative results makes it necessary staging another A. D. p. - PPD test, which is usually complements the sample Pirke and implemented by intradermal injection of 0.1 ml of diluted old tuberculin or purified protein fraction. A positive result is the appearance in 48-72 hour. papules not less than 5 mm in diameter (printing. table, Fig. 1). When setting PPD test is necessary to consider that a positive answer may be in children vaccinated against tuberculosis. Only firmly positive re reactions may indicate the presence of TB infection.
A. D. p. when brucellosis was proposed Byrne (that is, Burnet). An allergen use bracelin - filtrate monthly broth culture Brucella killed by heating at temperature of 80 degrees for 1 hour. The sample is put intradermally. The accounting is conducted in 24 hours. Positive reaction appears after 6-8 hours. and is expressed in swelling, pain and redness at the site of introduction of the allergen. Reaction Byrne sensitive and specific. A positive result is observed with 8-9-th day of illness, and long after recovery. A negative response, pointing to the absence of Allergy, does not exclude the disease.
Allergic diagnostic specimens with tularemia suggested L. M. Chatenever and other Allergen, tularik represents killed at temperature 70 degrees suspension of bacteria in glycerol-physiological solution. A. D. p. with tulainkom conducted by intradermal injection of 0.1 ml of the preparation. Consider the response in 24-48 hours. At a positive take on the introduction of the allergen see edema and hyperemia. During the test tulainkom possible side reactive phenomena: the deterioration of health, adenopathy, fever. The reaction is specific and appears with the 5th. day of the disease. As test with brocollino, test with tulainkom can be positive for a long time after the disease. A negative response does not exclude infection.
Allergic diagnostic specimens in Sapa carried out with the help of allergen mallein, which is a suspension killed 4-8 months culture bacteria in 4% glycerol broth. Reaction put cutaneous way similar to the sample Pirke. In veterinary practice using oftalmologie.
The reaction of Casoni is A. D. p. when echinococcosis. Allergen - sterile filtrate of fluids if Echinococcus bubble of Echinococcus lung or liver of cattle.
The sample spend intradermally. A positive reaction, occurring after 20 minutes, expressed in the appearance of whitish bubble surrounded by a wide damaged area in the form of merging Islands. In 24-48 hours getting late reaction in the form of infiltration.