Visitsunthorn Nualanong, Tiranathanakul Apiradee, Netrakul Rawee, Vichyanond Pakit
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2002 Aug;85 Suppl 2:S593-8.
Seafood is a common cause of food allergy in Thai adults and children. Skin prick test is a safe and convenient way to screen seafood allergy. To date, the Allergy Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University uses imported extracts for seafood skin prick test. The extracts are expensive and may not be the same species as seafood in Thailand.
To compare the consistency between local seafood allergen extracts prepared by the Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University and imported seafood allergen extracts.
The study was a prospective comparative trial performed in children who attended the Pediatric Allergy Clinic, Siriraj Hospital from March 1999 to October 2000. The skin prick test was performed with the local seafood allergen extracts prepared by a pharmacist from the Department of Pharmacology and the imported seafood allergen extracts included shrimp, fish and crab. Histamine and normal saline were used as positive and negative control respectively. The positive result was recorded when wheal reaction was > or = 3 mm larger than negative control.
Eighty eight patients (57 boys and 31 girls) were included in this study. The average age was 7.7 years (1-15 years). Half of the patients had a history of seafood allergy. The study showed probable consistency between imported and local skin prick test of shrimp and crab extracts (kappa = 5-7) but no consistency between imported and local skin prick test of fish extracts (kappa < 5). The study also showed no consistency between history of seafood and skin prick test result.
Local seafood allergen extracts from the Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University are safe but they cannot replace the imported seafood allergen extracts. Further investigations about sensitivity and specificity of both kinds of allergen extracts are necessary.
海鲜是泰国成人和儿童食物过敏的常见原因。皮肤点刺试验是筛查海鲜过敏的一种安全便捷的方法。迄今为止，玛希隆大学诗里拉吉医院儿科学系过敏科使用进口提取物进行海鲜皮肤点刺试验。这些提取物价格昂贵，而且可能与泰国的海鲜种类不同。
比较玛希隆大学诗里拉吉医院药学院制备的本地海鲜过敏原提取物与进口海鲜过敏原提取物之间的一致性。
该研究是一项前瞻性对比试验，于1999年3月至2000年10月在诗里拉吉医院儿科过敏门诊就诊的儿童中进行。使用药学院药剂师制备的本地海鲜过敏原提取物以及包括虾、鱼和蟹的进口海鲜过敏原提取物进行皮肤点刺试验。分别使用组胺和生理盐水作为阳性和阴性对照。当风团反应比阴性对照大≥3毫米时记录为阳性结果。
本研究纳入了88例患者（57例男孩和31例女孩）。平均年龄为7.7岁（1至15岁）。一半的患者有海鲜过敏史。研究表明，进口和本地虾及蟹提取物皮肤点刺试验之间可能具有一致性（kappa = 5 - 7），但进口和本地鱼提取物皮肤点刺试验之间无一致性（kappa < 5）。研究还表明海鲜过敏史与皮肤点刺试验结果之间无一致性。
玛希隆大学诗里拉吉医院药学院的本地海鲜过敏原提取物是安全的，但它们不能替代进口海鲜过敏原提取物。有必要对两种过敏原提取物的敏感性和特异性进行进一步研究。
