Giá trị của test da và kết quả giảm mẫn cảm nhanh với huyết thanh kháng dại tinh chế Sar

Abstract

This study evaluates the value of skin tests and clinical outcomes of patients desensitized with SAR – an equine rabies immunoglobulin (ERIG) manufactured in Vietnam. One hundred ninety-two patients who had positive results to skin tests or immediate hypersensitivity reactions (IHRs) with partial dose SAR at several preventive medicine institutes/centers; SAR intradermal test in 3 levels of dilution (1:10, 1:100, 1:1000) were performed with the negative control. The procedures followed ENDA/EAACI 2015 guideline. If the results were positive, SAR would be injected as a provocation method. Desensitization, then, was conducted if patients had any allergic reactions. Others were administered SAR normally under tight observations. Among 184 patients who had positive test results at other preventive medicine institutes, only 15,6% had the same results as at The Center of allergology and clinical immunology of Bach Mai Hospital. The negative predictive value of 3 dilutions mentioned are 97,3%, 96,2% and 89,3%, respectively. Twenty-seven patients were performed desensitizations. Twenty-six were successful and 1 undergone anaphylaxis (hypotension, urticaria, dyspnea). The latter was treated with continuous adrenaline infusion and stabilized after two days without any sequelae.  The IHRs rate of SAR is significantly higher than other ERIGs. We recommend that patients administered SAR require strict controls. The skin test should be standardized to improve diagnosis value. Desensitization is an effective therapy for patients at high risk of anaphylaxis.