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Provocation test on stairs: a new accessible method to cholinergic urticaria diagnosis
G Azizi1, S Dortas1, A França1
1Immunology Service, Hospital Universitário Clementino Fraga Filho (HUCFF-UFRJ), Rio de Janeiro, Brazil.
European Annals of Allergy and Clinical Immunology
|January 2, 2025
Summary
A new, low-tech test using stair climbing effectively diagnoses cholinergic urticaria (CholU) by measuring body temperature changes. This accessible method offers high sensitivity and specificity, particularly beneficial for developing countries.
Area of Science:
- Dermatology
- Allergy and Immunology
- Clinical Diagnostics
Background:
- Cholinergic urticaria (CholU) presents with itching and stinging due to systemic heat.
- Current diagnostic protocols involve exercise bikes or passive warming.
- There is a need for affordable, low-tech diagnostic tools for CholU.
Purpose of the Study:
- To develop and validate a new, accessible, low-tech diagnostic test for CholU.
- To assess the feasibility of using stair climbing as a provocation method.
- To evaluate body temperature changes as a diagnostic marker.
Main Methods:
- A cross-sectional study involving 10 CholU patients and 20 controls.
- A provocation test using stair climbing to increase heart rate by 90 bpm.
- Body temperature measured at three locations every 5 minutes.
Main Results:
- The stair climbing test demonstrated high diagnostic accuracy.
- Forehead temperature increases above 37.05°C with a 0.35°C variation showed 80% sensitivity and 100% specificity.
- Tympanic temperature measurements yielded 80% sensitivity and 90% specificity.
Conclusions:
- A simple stair-climbing test is a feasible and accessible method for diagnosing CholU.
- This method is particularly valuable for CholU diagnosis in resource-limited settings.
- The test utilizes readily available tools and can be implemented in developing countries.
