Assessment of the diagnostic performance of intradermal tuberculin test and post-mortem inspection for the diagnosis of bovine tuberculosis according to WOAH guidelines.

Bovine tuberculosis (bTB) constitutes a global challenge for public and animal health with still some deficiencies regarding its diagnosis. This study aimed to estimate the accuracy of the single intradermal tuberculin test (SIT) and post-mortem inspection for different diagnostic objectives following WOAH guidelines. Tissue samples from 59 microbiological culture/PCR-positive and 58 microbiological culture/PCR-negative cattle were evaluated. The diagnostic sensitivity and specificity, the positive and negative probability indices as well as the positive and negative predictive values (PPV and NPV) of each technique were estimated for different pretest probabilities. The SIT with strict interpretation demonstrated moderate precision in confirming the absence of infection in populations historically free of bTB, with a 12.1% rate of false positives, but also detecting positive animals in the early stage of the eradication programs, with a 13.6% rate of false negatives. The diagnostic performance for ruling out bTB was notably high (NPV > 90%) in animals with a pre-test probability (PTP) below 42%. Post-mortem inspection constituted an interesting alternative tool to confirm suspected and positive cases for SIT, particularly in areas with bTB prevalence exceeding 19%, where implementing SIT and eradication measures may be impractical. In these areas, the likelihood that animals with tuberculosis-like lesions are affected by the disease surpasses 90%. Similarly, in herds with a PTP below 25%, the absence of bTB could be confidently ruled out with over 90% certainty. These findings highlight the effectiveness of SIT and post-mortem inspection as valuable techniques for current eradication programs and controlling bTB in high-prevalence areas where molecular techniques may not be feasible.

The Diagnostic Value of Delayed-Type Reactions to Perennial Aeroallergens for Atopic Disease.

Background: Delayed-type reactions to aeroallergens have been observed, however, their clinical significance continues to be debated. Objective: We assessed the prevalence and significance of delayed-type reactions to aeroallergens in atopic patients. Methods: Retrospective study including 266 patients with history or evidence of atopic disease (atopic dermatitis [AD], allergic rhinitis, and/or allergic asthma) and tested via either the intradermal skin test (IDT) or atopy patch test for common aeroallergens, specifically house dust mites (Dermatophagoides farinae, Dermatophagoides pteronyssinus) and perennial molds (Aspergillus fumigatus, Penicillium notatum). All patients were tested via IDT with both immediate (15 minute) and delayed (2 and 4 days) readings. Delayed reading was considered positive if the IDT injection site demonstrated at least 5 mm induration 48 hours after inoculation. Results: In total, 195 (73.3%) patients demonstrated an immediate-type reaction, whereas 118 (44.4%) had a delayed-type reaction. In total, 75 (28.2%) patients experienced both immediate- and delayed-type reactions, 43 (16.2%) reacted delayed-type only, and 85.3% of delayed-type reactions to individual aeroallergens were associated with eczematous lesions predominantly in air-exposed areas. Conclusion: Delayed-type reactions to aeroallergens are prevalent and clinically significant as a component of extrinsic AD and atopic diseases. The data support delayed reading of the IDT to guide diagnosis and management in these patients.

Influence of a single oral dose of trazodone on intradermal histamine reactivity in clinically healthy dogs.

BACKGROUND: Drug interactions are significant considerations for intradermal testing (IDT). Trazodone (TRZ) is an anxiolytic and selective histaminergic (H1 ) antagonist with no interaction in human prick tests; however, interaction in canine IDT is unknown. HYPOTHESIS/OBJECTIVES: Trazodone will not adversely affect intradermal histamine reactions in dogs. ANIMALS: Fourteen nonanxious, nonatopic, healthy client-owned dogs were enrolled in this randomised, blinded, cross-over study. MATERIALS AND METHODS: Dogs were randomised to receive low-dose TRZ (4 mg/kg) (Teva Pharmaceuticals), high-dose TRZ (8 mg/kg) or no TRZ per os two hours before intravenous sedation with dexmedetomidine (5 mcg/kg) (Dexdomitor; Zoetis). Intradermal testing was performed with five quadrupling dilutions of histamine (1:100,000 to 1:25,600,000 w/v; Greer) and 0.9% saline (Hospira), observing a minimum two weeks washout period between treatments. Two observers, who were blinded to treatment and the identity of the injections, evaluated each test using previously established subjective and objective methods. RESULTS: The mean wheal diameter of histamine 1:1,600,000 w/v was significantly smaller with low-dose TRZ (4 mg/kg) compared to the control group (p = 0.048; repeated measures ANOVA with post hoc Tukey's test). For all other histamine dilutions and saline, mean wheal diameter was not significantly different among groups. There were no significant differences in the subjective scores of all histamine dilutions and saline (p > 0.05; Friedman test). CONCLUSION AND CLINICAL RELEVANCE: A single oral dose of TRZ does not adversely affect intradermal histamine reactions in dogs.

Investigation of the association between the Enferplex bovine tuberculosis antibody test and the future risk of bovine tuberculosis in irish cattle in infected herds: a pilot field study.

The Single Intradermal Comparative Tuberculin Test (SICTT) and the interferon-gamma (IFN-γ) assay are the approved diagnostic tests for bovine tuberculosis (bTB) in Ireland. The aim of this pilot study was to explore if there was any added diagnostic benefit from applying the Enferplex bTB test (an antibody test) in severe bTB herd breakdowns after the removal of cattle that had tested positive to the SICTT and the IFN-γ test. In addition to the normal bTB testing and management protocols, the animals in these herds that tested negative to SICTT and the IFN-γ test were followed forward for a period of two years. All animals were tested by Enferplex at enrolment. The time to subsequent bTB detection (diagnosed with SICTT/IFN-γ tests or detection of visible lesions at routine slaughter) for animals that tested positive or negative to the Enferplex bTB test at the start of the study was compared using Kaplan-Meier survival curves and Cox based survival models. Of the 484 enrolled animals (from 11 herds), 171 (35.3%) and 151 (31.1%) initially tested positive in the Enferplex assay under the high sensitivity and high specificity interpretation settings respectively. The results of the survival analysis showed that there was no difference in the survival time to a positive diagnosis with bTB during the follow-up period between animals initially classified as positive and negative by the Enferplex test. Further research is warranted to explore the potential benefit of using the Enferplex test in other scenarios.

A randomised, double-blinded trial to assess the effect of oclacitinib and prednisolone on intradermal allergen and prick tests in dogs with atopic dermatitis.

BACKGROUND: Intradermal (IDT) and prick (PT) tests are used to select allergens for allergen-specific immunotherapy in dogs with atopic dermatitis (cAD). However, the use of antipruritic drugs before performing these tests may influence the results. OBJECTIVE: To evaluate the influence of the drugs oclacitinib and prednisolone on the immediate-phase reactions of IDT and PT. ANIMALS: Thirty client-owned dogs with cAD with positive reactions to at least one allergen extract on IDT or PT. MATERIALS AND METHODS: Dogs were randomly assigned to receive oclacitinib 0.4-0.58 mg/kg per os, every 12 h (n = 14), or prednisolone 0.37-0.65 mg/kg p.o., every 12 h (n = 16) for 14 days. IDT and PT were performed on Day (D)0 before treatment and on D14. RESULTS: At D14 there was no significant reduction in the means of the orthogonal diameters of the positive immediate-phase reactions of the IDT (p = 0.064) in the oclacitinib group; however, in the PT, the diameter of the positive reactions reduced significantly (p = 0.048). In both tests, there was no significant reduction in the total number of positive reactions (IDT, p > 0.999; PT, p = 0.735). In the prednisolone group, the means of the orthogonal diameters of positive immediate-phase reactions were significantly reduced in both tests (IDT, p = 0.001; PT, p ≤ 0.001) and there also was a reduction in the total number of positive reactions (IDT, p = 0.022; PT, p = 0.001). CONCLUSIONS AND CLINICAL RELEVANCE: The use of oclacitinib 0.4-0.58 mg/kg twice daily for 14 days does not interfere with IDT results in dogs with cAD. However, oclacitinib may reduce PT reactivity. The use of prednisolone 0.37-0.65 mg/kg twice daily results in a reduction in both IDT and PT results.

Intradermal testing and serum allergen-specific IgE-testing in cats with naturally occurring feline bronchial disease.

OBJECTIVES: While feline asthma (FA) is considered to be of allergic origin, the etiology of feline chronic bronchitis (CB) to date is unknown. Aim of the study was to compare the results of intradermal testing (IDT) and serum testing for allergen-specific immunoglobulin E (SAT) in cats diagnosed with FA and CB. MATERIAL AND METHODS: Twenty-seven client-owned cats with clinical signs, suggestive of feline inflammatory bronchial disease (FBD) were prospectively enrolled in the study. Patients were assigned to 3 groups based on results of bronchoalveolar-lavage-fluid (BALF)-cytology: FA (n=8), CB (n=10), or cats with a physiological BALF cytology (PB; n=9). A standardized IDT for 27 allergens was performed in all cats. In addition, allergen-specific IgE was measured in serum samples using an FcεRIα-ELISA. The number of positive reactions in both tests was compared between groups, and agreement between test results of both tests was evaluated. RESULTS: Regarding the number of positive reactions, no statistically significant difference was detected between groups in IDT (p=0.65) and SAT (p=0.51). When comparing the 2 test systems, a weak correlation was found for the allergens Tyrophagus putrescentiae (k=0.256), Dermatophagoides farinae (k=0.276), and rye (k=0.273). The most commonly observed reactions were to house dust mites, storage mites, rye and nettle in IDT and to sheep sorrel, storage mites, and house dust mites in SAT. CONCLUSION AND RELEVANCE: IDT and SAT in cats with feline inflammatory bronchial disease (FBD) cannot be used interchangeably for allergen detection. Sensitization to environmental allergens can occur in cats with and without airway inflammation. Therefore, a positive test result should always be assessed in context with clinical signs and allergen exposure.

Characteristics and management of hypersensitivity reactions with rabbit anti-thymocyte globulin in pediatric patients.

Background: Anti-thymocyte globulin (ATG) has been successfully used for decades to prevent graft versus host disease before hematopoietic stem cell transplantation (HSCT) as a part of conditioning regimen. However, sometimes hypersensitivity reactions may limit its use. Objective: To evaluate hypersensitivity reactions experienced during rabbit-ATG infusion among children and present successful desensitization protocol. Methods: The medical records of pediatric patients who were given rabbit-ATG treatment at our tertiary center hospital HSCT unit between 2019 and 2022 were reviewed retrospectively. Diagnosis of the patients, age at the time of HSCT, gender, presence of hypersensitivity reaction to rabbit-ATG, and management were evaluated. Characteristics of the reaction and presence of hypersensitivity reaction to other drugs were also noted. If performed, desensitization protocols were evaluated retrospectively. Results: We evaluated 81 patients; 66.6% of them (n = 54) were boys. The mean age of the patients was 8.78 ± 5.48 years. Hypersensitivity to rabbit-ATG was seen in six patients (7.4%). Four of them (4.9%) had anaphylaxis; two (2.4%) had urticaria. Intradermal test performed to every patient before the first dose of ATG infusion was detected a positive result in 1 patient (1.2%) . None of these seven patients had allergic reactions to other drugs before. Successful ATG desensitization was performed in five patients by using a 12-16 step protocol due to patients' reaction severity. Conclusion: This study aimed to evaluate hypersensitivity reactions with rabbit-ATG in children. A successful desensitization protocol with rabbit-ATG is presented. Desensitization must be performed with an experienced team very carefully in the absence of alternative drug.

Pilot study to determine the concordance between skin prick and intradermal test (IDT) reactivity to environmental allergens in atopic dogs using IDT as the gold standard.

BACKGROUND: Prick testing is widely used as the first-line in vivo test for environmental allergens in people owing to its noninvasive nature and speed of performance. OBJECTIVES: To determine concordance between skin prick testing (SPT) and intradermal testing (IDT) reactivity to environmental allergen mixes in dogs with atopic dermatitis (cAD). ANIMALS: Forty client-owned dogs with cAD. MATERIALS AND METHODS: Skin prick testing (GREER Pick System; Stallergenes Greer) and IDT were performed on 40 dogs using seven glycerinated and aqueous environmental allergen mixes, respectively (tree, grass and weed pollens, house dust mites and three mould mixes). Reactions for IDT and SPT were evaluated both subjectively and objectively (mean wheal diameter; MWD) and compared to saline and histamine controls. RESULTS: Using IDT as the gold standard, with subjective scoring, SPT was 47.0% sensitive [95% confidence interval (CI) 36.0%-58.7%], 92.1% specific (95% CI 87.6%-95.3%) and agreement was moderate (79%, Cohen's kappa = 0.424). The positive predictive value of SPT was 36% and negative predictive value was 95%. Objective and subjective scores had only fair agreement. CONCLUSIONS AND CLINICAL RELEVANCE: Skin prick testing with allergen mixes was specific yet poorly sensitive as compared to IDT. For both IDT and SPT, 95% (38 of 40) dogs failed to react to an allergen mix, despite showing a positive reaction to at least one component. Future studies comparing SPT and IDT should test individual allergens rather than mixes to prevent the dilution of individual components, which may have resulted in false negatives.

Effect of glycerin on immediate cutaneous reactions of histamine (positive) and phosphate-buffered saline (negative) controls in intradermal skin testing of healthy dogs: A randomised, blinded study.

BACKGROUND: Glycerinated allergen extracts contain 50% glycerin, an excellent preservative. While glycerin is a recognised irritant in humans, the utility of glycerinated extracts for intradermal testing has not been validated in dogs. HYPOTHESIS/OBJECTIVE: To determine and compare the effects of glycerin on immediate cutaneous reactions to intradermal injections of histamine and saline in healthy dogs. ANIMALS: Eight healthy laboratory beagles. MATERIALS AND METHODS: The study was designed as a randomised, blinded study. Intradermal injections of histamine (positive control) and saline (negative control) in aqueous and glycerinated (50%) forms were performed on the right thorax. Global wheal scores (GWS) at 20 min were evaluated by two independent investigators blinded to the interventions. RESULTS: There were no wheal and flare reactions observed after the intradermal injections of phenolated saline. By contrast, 50% glycerosaline injections induced erythema and induration in all dogs. Global wheal scores were significantly higher in aqueous histamine (Friedman test, p < 0.0001) and 50% glycerinated histamine (Friedman test, p = 0.0084) compared to phenolated saline controls. Interestingly, only aqueous histamine (Friedman test, p = 0.01) had significantly higher GWS than 50% glycerosaline injections, while no significant difference in GWS between 50% glycerinated histamine and 50% glycerosaline groups was observed (Friedman test, p = 0.59). CONCLUSION AND CLINICAL RELEVANCE: This study demonstrates that intradermal injection of 50% glycerosaline induces erythema and induration skin reactions in healthy dogs that can mimic positive reactions to allergenic extracts. Further dilutions of glycerinated positive and negative control solutions need to be optimised for intradermal testing in dogs.

Post-orgasmic illness syndrome with positive intradermal test for autologous semen.

Post-orgasmic illness syndrome (POIS) is a rare disease characterized by flu-like symptoms persisting for 2-7 days after ejaculation. POIS has been chiefly attributed to allergic reactions to autologous seminal plasma. However, the exact pathophysiology remains unclear, and there is no effective treatment. We present the case of a 38-year-old man with a 10-year history of recurrent episodes of flu-like symptoms of 1-week duration after ejaculation. The patient was diagnosed with irritating bowel syndrome because of fatigue, myalgia, and lateral abdominal pain. After starting infertility treatment and increasing the frequency of intercourse with his wife, the patient noticed these symptoms after ejaculation. Based on these episodes and symptoms, POIS was suspected. To diagnose POIS, a skin prick test and an intradermal test were performed using his seminal fluid, with the latter yielding a positive result. The patient was diagnosed with POIS, and treatment with antihistamines was continued. Due to its rarity, POIS is often underdiagnosed and underreported; however, the skin test can be a valid diagnostic tool. In this case, the intradermal test result was positive according to the broadly accepted criteria for POIS. Although quality of life is often severely affected in patients with POIS, a lack of a clear understanding of the pathogenesis of POIS prevents early diagnosis. To make diagnoses earlier, it is undoubtedly important to take a detailed medical history and perform skin allergy tests, although the latter requires further validation.

Atopy, allergen sensitization and development of hypersensitivity reactions to paclitaxel.

BACKGROUND: Paclitaxel is a chemotherapeutic agent used in the treatment of multiple types of malignant tumors which was discovered from the Taxus brevofilia tree. In some patients, anaphylaxis develops during the first exposure to paclitaxel, suggesting that primary sensitization may have occurred through hidden or unidentified allergens that produce cross-reactivity. Skin testing may be useful in identifying sensitization to these allergens. Atopy has also been reported in patients with hypersensitivity reactions (HSR) to paclitaxel.The aim of this study is to evaluate the association between atopy and sensitization to allergens with the development of immediate HSR to paclitaxel. METHODS: Skin prick tests (SPT) for environmental and food allergens were applied to 76 patients recently diagnosed with cancer. A SPT to paclitaxel was applied and if negative, an intradermal test was performed. After paclitaxel's infusion, the development of immediate HSR was observed. RESULTS: Of 76 skin tests, 43% of patients had allergen sensitization and 57% did not. HSR occurred in 12.1% and 11.6% of each group, respectively. Five percent of patients tested positive to paclitaxel and only one had an immediate HSR. Eighty-nine percent of patients who developed an HSR had a family or personal history of atopy. CONCLUSIONS: Sensitization to environmental or food allergens does not appear to be a risk factor for the development of immediate HSR to paclitaxel, suggesting that there are other non-IgE-mediated immunologic mechanisms responsible for their development, however, a personal and family history of atopy increases 8x the risk of developing anaphylaxis.

Investigation of the diagnostic performance of prick test with two environmental allergens in dogs with atopic dermatitis: A study using intradermal test as the gold standard.

BACKGROUND: There are no studies investigating the correlation between prick test (PT) and intradermal test (IDT) with environmental allergens in dogs with atopic dermatitis (AD). OBJECTIVES: To investigate the correlation between PT and IDT for two environmental allergens, and to calculate the sensitivity, specificity and Youden index of PT, using IDT as the gold standard. MATERIALS AND METHODS: Twenty-two dogs with AD were selected. PT was performed with glycerinated allergen extracts, along with negative and positive controls, using the Greer Prick System. Reactions were interpreted (positive/negative) subjectively and by using seven objective criteria, by an examiner blinded to the IDT results. IDT reactions to the same allergens were interpreted, subjectively and objectively, by another masked investigator. The agreement between PT and IDT, the sensitivity, specificity and Youden index of PT, using IDT as gold standard, were calculated. RESULTS: On subjective evaluation, the correlation between PT and IDT was poor and sensitivity of PT was 0%. Of the seven criteria for the objective evaluation of PT, the best diagnostic performance was attained when allergen-induced wheals were considered positive if their longest diameter was ≥8.5 mm. However, even then, the correlation with IDT was moderate, and the sensitivity of PT, albeit based on few positive IDT reactions, was low. CONCLUSION AND CLINICAL RELEVANCE: At least as performed herein, PT has a poor-to-moderate correlation with IDT, mainly as a consequence of the lack of positive PT reactions. Further studies are needed to improve PT technique, yet, meanwhile, it cannot be recommended as a substitute for IDT.

Utility and Safety of Skin Tests in Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS): A Systematic Review.

BACKGROUND: Determination of culprit drug in drug reaction with eosinophilia and systemic symptoms (DRESS) is crucial. Skin tests have been used, although it remains unclear how sensitive these are. OBJECTIVE: To determine the value of skin tests in the assessment of drug causality in DRESS. METHODS: A systematic literature search was conducted for publications from 1996 onward of skin tests (skin prick test = SPT, patch test = PT, intradermal test = IDT) performed in clearly defined DRESS cases. Outcomes of testing, drug culpability assessments, and challenge test data were extracted. RESULTS: A total of 17 articles met inclusion criteria. In 290 patients with DRESS, patch testing was most frequent (PT = 97.2% [n = 282], IDT = 12.4% [n = 36], SPT = 3.1% [n = 9]). Positive results were noted in 58.4% (n = 160 of 282) of PTs, 66.5% of IDTs, and 25% of SPTs. When confidence of drug causality was high (n = 73 of 194), testing did not correlate well with clinical suspicion: PTs, 37.6%; IDTs, 36.5%. Direct comparison of skin testing with provocation testing (n = 12) showed 83.3% correlation. Positive IDT results were reported in 8 negative PT cases. CONCLUSIONS: Skin tests, particularly PTs and IDTs, have been reported as tools for diagnosis of causal drugs in DRESS. Heterogeneity in methodology, results analysis, and reporting of cohorts make meta-analysis to determine sensitivity and specificity of published literature impossible and highlight weaknesses in the field. We propose that international collaboration is essential to harmonize the methodology and reporting measures from hypersensitivity testing studies in larger cohorts.

Prevalencia de la infección por Sporothrix schenckii en agricultores del Cantón Shushufindi de la Provincia de Sucumbíos / Prevalence of Sporothrix schenckii infection in farmers of the Shushufindi Canton of the Sucumbíos Province

La esporotricosis es una micosis subcutánea causada por la inoculación traumática en la piel de especies de hongos del género Sporothrix. La enfermedad tiene diferentes manifestaciones clínicas (cutáneas, linfocutáneas y diseminadas), y también puede progresar a una infección sistémica. A pesar de tener una distribución mundial, la esporotricosis es más frecuente en los países tropicales y subtropicales. La esporotricosis es la micosis subcutánea más frecuente en América Latina, donde se considera endémica. Ciertos grupos de personas pueden estar más expuestos al agente causal de la enfermedad, como los agricultores. Así, este trabajo tuvo como objetivo determinar la prevalencia de la esporotricosis en 3.133 agricultores, en el cantón de Shushufindi de la provincia de Sucumbíos, Ecuador. En este estudio, se utilizó una prueba de intradermorreacción con el antígeno esporotriquina obtenido del hongo Sporothrix schenckii. Los datos obtenidos mostraron una prevalencia de 35,45%. La distribución de la prevalencia de la esporotricosis con respecto a los grupos de edad no mostró diferencias estadísticas significativas (p=0,2054). Para la variable sexo, si hubo significancia estadística (p=0,01995). 51 de los casos positivos presentaron gomas y/o úlceras en alguno de sus miembros. La esporotricosis ha demostrado ser una de las micosis subcutáneas más frecuente en los trabajadores de la agricultura en la región ecuatoriana evaluada(AU)

Sporotrichosis is a subcutaneous mycosis caused by traumatic skin inoculation of fungal species of the genus Sporothrix. The disease has different clinical manifestations (cutaneous, lymphocutaneous, and disseminated), and it can also progress to a systemic infection. Despite having a worldwide distribution, sporotrichosis is more common in tropical and subtropical countries. Sporotrichosis is the most frequent subcutaneous mycosis in Latin America, where it is considered endemic. Certain groups of people may be more exposed to the causative agent of the disease, such as farmers. Thus, this work aimed to determine the prevalence of sporotrichosis in 3133 farmers, in the canton of Shushufindi in the province of Sucumbíos, Ecuador. In this study, an intradermal test was used with the sporotrichin antigen obtained from the fungus Sporothrix schenckii. The data obtained showed a prevalence of 35.45%. The distribution of the prevalence of sporotrichosis with respect to age groups did not show significant statistical differences (p=0.2054). For the sex variable, there was statistical significance (p=0.01995). 51 of the positive cases presented gums and/or ulcers in one of their members. Sporotrichosis has proven to be one of the most frequent subcutaneous mycoses in agricultural workers in the evaluated Ecuadorian region(AU)

Repeatability and reproducibility of the interpretation of intradermal test results in dogs with atopic dermatitis.

Background - There is lack of studies evaluating the repeatability and reproducibility of the interpretation of intradermal testing in dogs with atopic dermatitis (AD). Objectives - To evaluate the repeatability and reproducibility of the interpretation of intradermal test results in dogs with AD. For comparison, the repeatability of allergen-specific immunoglobulin (Ig)E serology also was examined. Materials and methods - Twenty dogs with AD were used. Intradermal test included injections of known negative and positive controls, and of 25 masked injections of 10 allergens/controls, that were selected randomly and injected at random positions. Reactions to the 25 masked allergens/controls were scored (positive/negative) subjectively by three independent examiners followed by an objective assessment. Allergen-specific IgE serology was performed in blinded duplicate samples collected from all dogs for nine of 10 of the same allergens. Results - Kappa values of intraobserver repeatability (≥2 injections of the same allergen to different positions of the same dog) varied between -0.53 and 0.8 (subjective evaluations), and between 0.03 and 1 (objective evaluation). When the repeatability of the serological test was examined k = 0.91. Kappa values for the interobserver reproducibility (objective and three subjective evaluations of the same allergen injected at the same position of the same dog) varied between 0.6 and 0.74 (overall 0.67). Conclusions and clinical relevance - Intraobserver repeatability of the subjective and objective evaluation of IDT results varied from good to poor and depended on the number of times the same allergen was injected, whereas interobserver reproducibility varied from substantial to moderate. Further studies are needed to optimise the repeatability and reproducibility of IDT in dogs.

Contexte - Il existe un manque d'études évaluant la répétabilité et la reproductibilité de l'interprétation des tests intradermiques chez les chiens atteints de dermatite atopique (DA). Objectifs - Évaluer la répétabilité et la reproductibilité de l'interprétation des résultats des tests intradermiques chez les chiens atteints de MA. À des fins de comparaison, la répétabilité de la sérologie de l'immunoglobuline (Ig)E spécifique de l'allergène a également été examinée. Matériels et méthodes - Vingt chiens atteints de MA ont été utilisés. Le test intradermique comprenait des injections de contrôles négatifs et positifs connus, et de 25 injections masquées de 10 allergènes/contrôles, qui ont été sélectionnés au hasard et injectés à des positions aléatoires. Les réactions aux 25 allergènes/contrôles masqués ont été notées (positives/négatives) subjectivement par trois examinateurs indépendants, suivies d'une évaluation objective. La sérologie IgE spécifique de l'allergène a été réalisée dans des échantillons en double en aveugle prélevés sur tous les chiens pour neuf des 10 allergènes identiques. Résultats - Les valeurs kappa de répétabilité intra-observateur (≥2 injections du même allergène à différentes positions du même chien) variaient entre -0,53 et 0,8 (évaluations subjectives), et entre 0,03 et 1 (évaluation objective). Lorsque la répétabilité du test sérologique a été examinée, k = 0,91. Les valeurs de Kappa pour la reproductibilité interobservateur (évaluations objective et trois évaluations subjectives du même allergène injecté au même endroit du même chien) variaient entre 0,6 et 0,74 (globalement 0,67). Conclusions et pertinence clinique - La répétabilité intra-observateur de l'évaluation subjective et objective des résultats IDT variait de bonne à mauvaise et dépendait du nombre d'injections d'un même allergène, alors que la reproductibilité inter-observateur variait de substantielle à modérée. D'autres études sont nécessaires pour optimiser la répétabilité et la reproductibilité de l'IDT chez le chien.

Introducción- faltan estudios que evalúen la repetibilidad y la reproducibilidad de la interpretación de las pruebas intradérmicas en perros con dermatitis atópica (AD). Objetivos- evaluar la repetibilidad y reproducibilidad de la interpretación de los resultados de las pruebas intradérmicas en perros con AD. A modo de comparación, también se examinó la repetibilidad de la serología de inmunoglobulina (Ig)E específica de alérgeno. Materiales y métodos - Se utilizaron 20 perros con AD. La prueba intradérmica incluyó inyecciones de controles positivos y negativos conocidos, y de 25 inyecciones enmascaradas de 10 alérgenos/controles, que se seleccionaron al azar y se inyectaron en posiciones aleatorias. Las reacciones a los 25 alérgenos/controles enmascarados fueron calificadas (positivas/negativas) subjetivamente por tres examinadores independientes seguido de una evaluación objetiva. La serología de IgE específica para alérgenos se realizó en muestras duplicadas ciegas recolectadas de todos los perros para nueve de 10 de los mismos alérgenos. Resultados - Los valores Kappa de repetibilidad intraobservador (≥2 inyecciones del mismo alérgeno en diferentes posiciones del mismo perro) variaron entre -0,53 y 0,8 (evaluaciones subjetivas) y entre 0,03 y 1 (evaluación objetiva). Cuando se examinó la repetibilidad de la prueba serológica k = 0,91. Los valores de Kappa para la reproducibilidad interobservador (objetivo y tres evaluaciones subjetivas del mismo alérgeno inyectado en la misma posición del mismo perro) variaron entre 0,6 y 0,74 (en general, 0,67). Conclusiones y relevancia clínica- la repetibilidad intraobservador de la evaluación subjetiva y objetiva de los resultados de la IDT varió de buena a mala y dependió del número de veces que se inyectó el mismo alérgeno, mientras que la reproducibilidad interobservador varió de sustancial a moderada. Se necesitan más estudios para optimizar la repetibilidad y reproducibilidad de IDT en perros.

Contexto - Há poucos estudos avaliando a repetibilidade e reprodutibilidade da interpretação do teste intradérmico em cães com dermatite atópica (DA). Objetivos - Avaliar a repetibilidade e reprodutibilidade da interpretação dos resultados de testes intradérmicos em cães com DA. Para comparação, a repetibilidade da sorologia com imunoglobulinas (Ig)E alérgeno-específicas foi também avaliada. Materiais e métodos - Foram utilizados 20 cães com DA. O teste intradérmico incluiu injeções de controles negativos e positivos conhecidos e de 25 injeções mascaradas de 10 alérgenos/controles, que foram selecionados aleatoriamente e injetadas em posições aleatórias. As reações aos 25 alérgenos/controles mascarados foram pontuadas (positiva/negativa) subjetivamente por três examinadores independentes, seguidas de uma avaliação objetiva. A sorologia de IgE específica para alérgenos foi realizada em amostras duplicadas cegas coletadas de todos os cães para nove de 10 dos mesmos alérgenos. Resultados - Os valores Kappa de repetibilidade intraobservador (≥2 injeções do mesmo alérgeno em diferentes posições do mesmo cão) variaram entre -0,53 e 0,8 (avaliação subjetiva) e entre 0,03 e 1 (avaliação objetiva). Quando examinada a repetibilidade do teste sorológico k=0,91. Os valores de Kappa para a reprodutibilidade interobservador (objetiva e três avaliações subjetivas do mesmo alérgeno injetado na mesma posição do mesmo cão) variaram entre 0,6 e 0,74 (total 0,67). Conclusões e relevância clínica - A repetibilidade intraobservador da avaliação subjetiva e objetiva dos resultados do IDT variou de boa a ruim e dependeu do número de vezes que o mesmo alérgeno foi injetado, enquanto a reprodutibilidade interobservador variou de substancial a moderada. Mais estudos são necessários para otimizar a repetibilidade e reprodutibilidade do IDT em cães.

THE USE OF INTRADERMAL SKIN TESTING AND HYPOSENSITIZATION INJECTIONS TO CONTROL SEASONAL DERMATITIS IN GREATER ONE-HORNED RHINOCEROSES (RHINOCEROS UNICORNIS).

Allergic dermatitis was diagnosed in a 25-yr-old female greater one-horned rhinoceros (Rhinoceros unicornis) and her 6-yr-old female offspring by skin biopsy, intradermal skin testing (IDST), and allergen-specific serum IgE testing. Dam and offspring presented with seasonal, erosive, and ulcerative dermatitis affecting the face, legs, and trunk starting at 6 and 2 yr of age, respectively. IDST was performed at the caudal pinnal base using 61 regionally specific allergens. Specific serum allergen responses were detected using Heska's Equine ALLERCEPT® Allergen Panel. Histopathology of the lesions was consistent with an allergic etiology. Injectable allergen-specific immunotherapy was initiated in both animals and within 6 to 18 mon after commencing hyposensitization clinical improvement was noted. This report documents a repeatable methodology for IDST and serological allergen testing for use in rhinoceroses. The hyposensitization protocol detailed here can help guide future treatment protocols.