Abstract

The purpose of this study was to determine the sensitivity advantage of intradermal dilutional testing (IDT) in the diagnosis of allergy in patients with various atopic diseases such as chronic sinusitis, allergic rhinitis, asthma or otitis media with effusion. This retrospective, private-practice cohort study compared the sensitivity of skin prick tests (SPT) vs. IDT in 110 adults and children with suspected allergy. This retrospective, private-practice cohort study compared the sensitivity of SPT vs. IDT in 110 adults and children with suspected allergy. Primary outcome measure was symptom resolution from allergy immunotherapy (AIT). IDT identified 57% more patients as being allergic, and 8.6 times more reactive allergens than would have been diagnosed using only Skin Prick Testing (SPT). IDT identified 57% more patients as being allergic, and 8.6 times more reactive allergens than would have been diagnosed using only SPT. Patients diagnosed by IDT had the same degree of symptom improvement from immunotherapy, independent of allergen sensitivity (66% by SPT vs. 63% by IDT; p = 0.69, not different). Low-sensitivity allergy tests, which may fail to identify allergy in over two thirds of children aged 3 to 15 as being a topic, or among 60% of patients with middle ear disease, may explain why many physicians do not consider allergy as a treatable etiology for their patient’s allergies. IDT offers superior sensitivity over SPT for detecting allergens clinically relevant to treating allergy. These data strongly support increased utilization of intradermal testing and invite additional clinical outcome studies.