Ogura Y, Ogura H, Zushi N, Morita H, Kurashige T
Department of Pediatrics, Atago Hospital.
Arerugi. 1993 Jun;42(6):748-56.
To clarify the diagnostic value of the radioallergosorbent test (RAST), the relationship between RAST and the oral food challenge test was evaluated. 263 children with atopic dermatitis were challenged by egg, cow's milk or soy bean after their skin manifestations had been improved by elimination diet and environmental control. Of 200 cases with negative RAST results for egg white, 108 cases (54.0%) showed no reaction in egg challenge tests. However, 65 cases (31.5%) had non-immediate reactions, while 29 cases (14.5%) had immediate reactions (within 2 hours of challenge). Of 16 cases with RAST score of 1 for egg white, 11 cases (68.8%) had non-immediate reactions and 2 cases (12.5%) had immediate reactions in egg challenge tests. Of 19 cases with RAST scores of 2 for egg white, 2 cases (10.5%) had no reaction, 6 cases (31.6%) had non-immediate reactions and 11 cases (57.9%) had immediate reactions in egg challenge tests. Of 21 cases with RAST scores of 3 for egg white, 1 case (4.8%) had no reaction, 3 cases (14.3%) had non-immediate reactions and 17 cases (81.0%) had immediate reactions in egg challenge tests. All 7 cases with RAST scores of 4 for egg white had immediate reactions in egg challenge tests. Almost the same relationship between RAST and challenge tests were found in test using cow's milk or soy bean. In conclusion, false negative results were seen in 46.0% of RAST for egg white, 51.7% of RAST for cow's milk and 26.9% of RAST for soy bean.(ABSTRACT TRUNCATED AT 250 WORDS)
为阐明放射变应原吸附试验(RAST)的诊断价值,评估了RAST与口服食物激发试验之间的关系。263例特应性皮炎患儿在通过排除饮食和环境控制使皮肤症状改善后,接受了鸡蛋、牛奶或大豆激发试验。在200例蛋清RAST结果为阴性的病例中,108例(54.0%)在鸡蛋激发试验中无反应。然而,65例(31.5%)有非速发型反应,29例(14.5%)有速发型反应(激发后2小时内)。在16例蛋清RAST评分为1的病例中,11例(68.8%)有非速发型反应,2例(12.5%)在鸡蛋激发试验中有速发型反应。在19例蛋清RAST评分为2的病例中,2例(10.5%)无反应,6例(31.6%)有非速发型反应,11例(57.9%)在鸡蛋激发试验中有速发型反应。在21例蛋清RAST评分为3的病例中,1例(4.8%)无反应,3例(14.3%)有非速发型反应,17例(81.0%)在鸡蛋激发试验中有速发型反应。所有7例蛋清RAST评分为4的病例在鸡蛋激发试验中均有速发型反应。在牛奶或大豆试验中,RAST与激发试验之间也发现了几乎相同的关系。总之,蛋清RAST中有46.0%出现假阴性结果,牛奶RAST中有51.7%出现假阴性结果,大豆RAST中有26.9%出现假阴性结果。(摘要截选至250字)