[Allergentesting in children with asthma bronchiale (author's transl)]

Abstract

The results of altogether 938 intradermal tests and 298 bronchial challenges with 14 allergens are presented. 67 non selected asthmatic children from 5 1/2 to 14 years of age were studied in symptom free period: 1.298 intradermal tests( 31.8% of all tests) were positive. Of these positive reactions 61.2% were positive to grasses; 55.2% to rye; 50.7% to wheat; 44.7% to house-dust, 40.3% to cat; 37.3% to horse; 19.4% to molds and 24.4% to feathers.--2. We performed the bronchial inhalation tests by the allergens, which had positive reactions in the skin (n = 298). 193 of these bronchial inhalation tests were negative (no obstruction of the bronchies), this is 2/3 of all intradermal tests with positive reactions.--3. 105 of the 298 bronchial inhalation tests were positive, that means an increased total lung resistance during inhalation of the allergen. These 105 positive reactions of the bronchies were shown in only 44 of the 67 children: in 23 children with positive intradermal reactions it was not possible to provoke a bronchus obstruction after inhalation of the corresponding allergens. Of the 44 children with bronchusobstruction during allergen inhalation 55% had a reaction to grasses; 43.2% to rye; 31.8% to horse; 31.8% to cat; 29.5% to wheat; 11.4% to house-dust and 6.8% to molds. No child reacted by bronchus-obstruction after inhalation of feathers.--4.13 of the 67 children showed a severe hyperirritability of the bronchies after inhalation of histamin: threshold below 1000 y/ml of histamin. In 9 children, the threshold for histamin was not diminished in comparison to healthy children.--The method fo the so-called controlled bronchial inhalation test is described and compared to other methods. We did not observe any incidents. In 8 of 105 cases the provoked bronchus obstruction was not completely reversible after inhalation of a bronchodilator, but now severe clinical symptoms of bronchial obstruction remained evident. We observed "late" reaction in the following 8-24 hrs after inhalation of house-dust in more than 50% of the positive tests, after inhalation of the other allergens only in 2%. By bronchial inhalation tests we select of all allergens with a positive reaction in the skin only those, which provoke a bronchus obstruction. The hyposensitization is performed by these selected allergens only.