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Value of the case history in the diagnosis of allergic state and the detection of allergens

Authors

  • A. PÉCOUD,

    1. Division d'Immunologie et d'Allergie, Centre Hospitaller Universilaire Vaudois, Lausanne, Switzerland
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  • H. S. BONSTEIN,

    1. Division d'Immunologie et d'Allergie, Centre Hospitaller Universilaire Vaudois, Lausanne, Switzerland
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  • P. C. FREI

    Corresponding author
    1. Division d'Immunologie et d'Allergie, Centre Hospitaller Universilaire Vaudois, Lausanne, Switzerland
      P. C. Frei, Division d'Immunologieet d'Allergie CHUV, CH-1011 Lausanne, Switzerland.
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P. C. Frei, Division d'Immunologieet d'Allergie CHUV, CH-1011 Lausanne, Switzerland.

Summary

Detailed histories taken in eighty-one patients suffering from perennial asthma and rhinitis were analysed independently by three trained allergists and their conclusions were compared to the results of three tests: (1) concentration of total serum IgE; (2) skin tests and (3) radioallergosorbent test (RAST). In eleven patients (14%), the three investigators disagreed when estimating the allergic nature of the symptoms. Ten out of forty-four patients (23%), unanimously predicted not to be allergic, had high levels of total serum IgE and skin tests and RAST clearly positive for one or more allergens. The allergists suspected 47% of the allergens detected by skin tests and 55% of those detected by RAST. The case history was the test which most often gave information at odds with that suggested by the other three tests. Our study indicates therefore that a case history not even suggestive of allergy should be complemented by additional tests.

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