Schimmelpennink, M. (Milou) (2014) Insectenallergie. Evaluatie van risico van dermale reactors en kwaliteit van leven. thesis, Medicine.
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Abstract
Background: The recurrence risk of systemic reactions in dermal reactors with wasp allergy is 9,1% to 33,3%. Because of insufficiency of present diagnostic methods there is a lack of correlation between clinical sensitivity and immunologic reactivity. Severity of the reaction is correlated to the recurrence risk of a systemic reaction. Also, the severity of a re-sting reaction is related to the severity of the initial reaction, in most cases there is no progression in severity. Due to a minimal risk of a life-threatening system reaction, the prescription of VIT is controversial with dermal reactors. In this study the risk for a systemic reaction in dermal reactors with wasp allergy will be determined by three provocation tests. Methods: In this prospective longitudinal study three provocation tests with a living insect were done in 22 dermal reactors allergic to wasps. When a systemic reaction more than a dermal reaction occurred no more provocation tests were undertaken and VIT was offered. After three negative provocation tests the recurrence risk was considered comparable to the risk in the normal population. Arising from this there was neither an indication for AAI nor an indication for VIT. Also, we researched the risk of sensitizing patients with a provocation test. Therefore the baseline sIgE was determined and subsequently sIgE was determined after each provocation test. Results: Five patients had a grade I reaction according to Mueller. Four patients reacted after the first provocation test and one patient reacted after the third provocation test. In this study there was no trend in serologic sIgE. Conclusion: The recurrence risk of systemic reactions in dermal reactors with wasp allergy after three provocation tests is 22.7%. It seems likely that provocation tests do not sensitize patients. However, the moments of determination of sIgE were inconsequent and because of the small number of patients it is too early to draw any conclusions.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Oude Elberink, Dr. J.N.G. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:49 |
| Last Modified: | 25 Jun 2020 10:49 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/993 |
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