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[Comparative study of 3 positive controls for routine prick tests in children: 48/80, 1 mg histamine and 5 mg
M Lelong1, M Thibaudon, J Polaert
1Service de Pédiatrie, Centre Hospitalier, Lens.
Insights
Compound 48/80 is the best positive control for pediatric allergy prick tests. Intermediate histamine concentrations may offer an alternative to current methods for allergy testing in children.
Area of Science:
- Allergy and Immunology
- Dermatology
- Pediatrics
Background:
- Prick testing is crucial for diagnosing immediate allergies in children.
- Selecting an appropriate positive control is essential for test validity.
Purpose of the Study:
- To evaluate the efficacy of different positive control solutions for skin prick tests in children.
- To determine the optimal positive control for immediate allergy diagnosis in pediatric patients.
Main Methods:
- A Stallerpoint device was used for prick tests on 153 children aged 2-14 years.
- Responses to Compound 48/80 and varying concentrations of histamine (1 mg/ml and 5 mg/ml) were compared.
Main Results:
- Compound 48/80 yielded consistent positive reactions (4.46 +/- 1.88 mm).
- 1 mg/ml histamine produced excessive null responses (12/153), limiting its utility.
- 5 mg/ml histamine resulted in overly strong reactions, potentially underestimating allergen responses.
Conclusions:
- Compound 48/80 is the most reliable positive control for pediatric allergy prick testing.
- A histamine concentration of 2.5 mg/ml could be a viable alternative positive control.
Abstract:
We compared, among 153 children 2 to 14 years old, responses to some positive control solutions for prick tests made with a Stallerpoint. We obtained the following values: -6% - 48/80:4.46 +/- 1.88 mm -1 mg/ml Histamine:3.49 +/- 1.67 mm -5 mg/ml Histamine:5.13 +/- 1.78 mm. 1 mg/ml histamine gives too many null responses (12/153) to represent a valuable positive control. 5 mg/ml histamine, on the other hand, gives some very strong reactions which may induce an underestimation of responses to allergen tests. Compound 48/80 seems to remain the best positive control for prick test exploration of immediate allergy in children. An alternative might be an intermediate solution of histamine 2.5 mg/ml.