Comparison of the skin-prick test and Phadia ImmunoCAP as tools to diagnose house-dust mite allergy

Background: When the skin-prick test (SPT) and in vitro test such as ImmunoCAP assay are performed simultaneously, results do not always coincide in some patients. Our objectives, therefore, were (1) to assess differences in allergic test results according to age group and (2) to establish appropriate guidelines for diagnosing mite allergy according to age. Methods: A total of 692 participants complaining of allergic rhinitis symptoms participated. Patients were divided according to age; the mean age was 32 years (range, 8-76 years). The SPT and ImmunoCAP assays were performed to detect allergies to house-dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae). The association between age and the result of each allergy test were examined, and a cutoff age for proper application of each test was than estimated. Results: Three hundred thirty-six patients (48.6%) were allergic to D. pteronyssinus and 350 patients (50.6%) were allergic to D. farinae. In the case of D. pteronyssinus, SPT was proved to be more useful in detecting allergy for subjects <50 years old (p < 0.0001). However in case of D. farinae, ImmunoCAP was useful for all age groups, but SPT showed decreased ratio of positive result for subjects >30 years old (p < 0.0001). Conclusion: This study was the first to compare results of allergy tests according to age using true allergens. For patients >50 years of age, the ImmunoCAP was found to be the preferred method for detecting allergy to house-dust mites and for patients <30 years old, SPT is the recommended first choice. (Am J Rhinol Allergy 24, 226-229, 2010; doi: 10.2500/ajra.2010.24.3459)