Efficacy Of Nasal Allergen Provocation Test In The Diagnosis Of Dermatophagoides Pteronyssinus Allergic Rhinitis.
Monday, March 5, 2018
South Hall A2 (Convention Center)
Jose S. Rodriguez Canosa, MSc, Sandy Stephanie Aguilar Gavilanes, MD, Raúl Lázaro Castro Almarales, MD, Mirta Álvarez Castelló, MD, Belkis Lopez Gonzalez, MD., Mercedes Ronquillo Diaz, MSc, Mayda González León, MD, Wendy Ramirez Gonzalez, MSc, Bárbara Ivonne Navarro Viltre, MD, Maivis Cabrera Quiala, MD, Maytee Mateo Morejon, MSc, Mary Carmen Reyes Zamora, MD, Alexis Labrada Rosado, PhD.

A nasal allergen provocation test (NAPT) is performed to confirm the diagnosis of allergic rhinitis to house dust mite, in the situation of discrepancy between the symptoms and the results of skin prick test (SPT) and/or serum specific immunoglobulin E. In Cuba, sensitization to house dust mites (Dermatophagoides pteronyssinus (Dp), Dermatophagoides siboney and Blomia tropicalis) is a major cause of allergic rhinitis. Objective: To demonstrate the efficiency of NAPT with an allergenic extract of Dermatophagoides pteronyssinus.


Hundred adults between 18 and 45 years were included. Fifty with allergic rhinitis had positive skin prick tests (SPTs) to Dp and fifty healthy individuals. NAPTs were performed by instillation with dropper (4 drops) of the Dp extract to five concentrations (2, 20, 200, 2000 and 20000 BU/ml) in nostril at 15 minute interval. Efficacy was demonstrated by the calculation of sensitivity, specificity and efficiency.


Nasal allergen provocation test with Dp extract was positive in the 94% (47/50 patients) of sensitized allergic rhinitis to Dp. As the sensitivity as specificity were high of 94% and 100%, respectively. While, efficiency was 97% (95%CI: 99-100). Furthermore, Area under the ROC curve was 0.970 (0.95-1.0) and a p<0.0001. Another hand, a significant correlation (Spearman, r=0.846; p <0.0001) between the skin reactivity and NAPT response. Eleven non-specific adverse reactions were registered in allergic rhinitis.


Nasal allergen provocation test with the Dermatophagoides pteronyssinus is effective and safety by the diagnosis of allergic rhinitis to this mite.