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Related Experiment Videos

Skin testing for chymopapain allergy in chemonucleolysis.

H M Mayer, M Wehr, M Brock

    Surgical Neurology
    |March 1, 1986
    PubMed
    Summary

    Chymopapain chemonucleolysis can cause anaphylaxis. Skin prick tests identify patients at risk, significantly improving safety by excluding those with positive reactions before the procedure.

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    Area of Science:

    • Allergy and Immunology
    • Minimally Invasive Procedures

    Background:

    • Chemonucleolysis using chymopapain carries a risk of unpredictable anaphylactic reactions, with reported rates between 0.35% and 1.5%.
    • Serological tests like RAST and ChymoFAST, along with skin prick tests, are utilized to detect elevated immunoglobulin E antibody titers against chymopapain.

    Purpose of the Study:

    • To evaluate the efficacy of skin prick testing in identifying patients susceptible to anaphylactic reactions from chymopapain chemonucleolysis.
    • To assess the safety enhancement of excluding patients with positive skin test results prior to the procedure.

    Main Methods:

    • A skin prick test was administered to 257 patients, including Discase, Chymodiactin, and Solutrast 250 M.
    • 222 patients were tested before chemonucleolysis, and 35 were tested after the procedure.
    • Skin test results were analyzed for correlation with previous allergy history and time post-chemonucleolysis.

    Main Results:

    • Before chemonucleolysis, 2.3%-3.3% of patients showed positive skin tests.
    • Following chemonucleolysis, the allergy rate increased to 42.9%, with over 70% testing positive between weeks 3 and 12.
    • No correlation was found between a history of allergy and skin test outcomes.

    Conclusions:

    • Patients with positive skin prick test results should be excluded from chymopapain chemonucleolysis to prevent anaphylaxis.
    • Pre-procedure skin testing significantly enhances patient safety.
    • Over 350 patients treated with negative skin prick tests experienced no anaphylactic reactions.

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