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Reliability of control skin tests with common antigens in children undergoing tuberculin skin test

Michal Stein1, Batia Sela-Razon, Yeshayaou Kleter

  • 1Pediatric Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel.

Annals of the New York Academy of Sciences
|September 6, 2007
PubMed

Insights

Skin tests using common antigens like diphtheria-tetanus (DT) and candida are unreliable for assessing delayed-type hypersensitivity in children. These tests show a high false-negative rate and may not accurately detect anergy.

Area of Science:

  • Immunology
  • Pediatric Medicine

Background:

  • Assessing delayed-type hypersensitivity (DTH) is crucial in pediatric care.
  • Tuberculin skin test (TST) is a common method, but its reliability can be affected by other immune responses.

Purpose of the Study:

  • To evaluate the reliability of common skin tests (diphtheria-tetanus vaccine and candida antigens) in assessing DTH in children.
  • To determine if these tests can predict a state of anergy.

Main Methods:

  • A cohort of 52 children from developing countries undergoing TST prior to heart surgery were included.
  • Skin tests with diphtheria-tetanus (DT) vaccine and candida antigens were performed alongside TST.
  • Response rates to DT and candida antigens were compared, and analyzed in relation to TST results and patient age.

Main Results:

  • A significant proportion of children reacted to DT (81%) and candida (38%) antigens.
  • No correlation was found between responses to DT or candida antigens and TST results.
  • Age did not significantly influence the response to DT or candida antigens.

Conclusions:

  • Skin tests with common antigens (DT, candida) exhibit a high false-negative rate in children.
  • These tests are not reliable predictors of a delayed-type hypersensitivity response or a state of anergy.
  • Further research is needed to identify reliable methods for assessing DTH in pediatric populations.

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