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Delayed‐type allergy to cobalt—comparison of a flow cytometric lymphocyte proliferation test with patch testing
Author(s) -
Spoerri Iris,
Bircher Andreas J.,
Link Susanne,
Heijnen Ingmar A. F. M.,
Scherer Hofmeier Kathrin
Publication year - 2018
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/cod.12990
Subject(s) - patch test , contact allergy , sensitization , patch testing , lymphocyte , immunology , medicine , allergy , contact dermatitis
Background The patch test is the standard procedure for diagnosing delayed‐type sensitization. If a patch test is not possible, the flow cytometric lymphocyte proliferation test (LPT), which determines the number and type of cells responding to a specific antigen in vitro, might be considered as an alternative. Objectives Our aim was to establish a flow cytometric LPT for the detection of delayed‐type allergic responses to cobalt, and to determine the correlation between stimulation indices (SIs) in LPT and the grade of patch test reactions. With the patch test as a diagnostic reference, we also assessed the sensitivity and specificity of the LPT. Methods Fifty‐four patients patch tested with the baseline series including cobalt (CoCl 2 ) were additionally tested with the flow cytometric LPT with CoCl 2 . Results There was a significant correlation between the results of both tests: r s = 0.43; P = .001. The LPT with CoCl 2 showed a sensitivity of 52.6% and a specificity of 85.7%. Corresponding to the low sensitivity of the LPT, high likelihood ratios for a positive patch test reaction were reached only in cases of strong lymphocyte proliferation (SI ≥ 10). Conclusions In cases of clearly increased SIs, the flow cytometric LPT with CoCl 2 gives relevant diagnostic information, and represents a valuable alternative to patch testing.