アレルギー性鼻炎における皮膚反応の意義と誘発試験

THE SIGNIFICANCE OF SKIN-REACTION IN NASAL ALLERGY AND ITS INDUCTION TEST

　アトピー型アレルギーの特徴は皮膚反応が陽性に出ることであり，アレルギー性鼻炎患者の診断，治療にアレルゲン抽出液による皮膚試験がいかに有用であるかはすでに当教室より報告されている^1）。しかし皮膚反応が陰性でも典型的なアレルギー性鼻炎の症状を有するものがあり，反応陽性でもアレルギー症状がなかつたり，症状があつても誘発試験陰性，鼻汁，鼻粘膜内好酸球がみられなかつたり，減感作療法が無効である例も少なくない。細菌性，食餌性，薬物性アレルギーの場合より吸入性アレルギーでは皮膚反応に信頼性が強いといわれている^2）。臨床的な面からその信頼性について，2,3の検討を行なつた。

A mass allergic tests were conducted on 92 5 th grade school children, aged 11. Among these who were had no symptom of allergyskin-tests were carried out with house dust and ragweed pollen; 32% were positive to house dust and 21% to ragweed pollen. When similar test were made on adults without any symptom of allergy and previous allergic history the positive reaction was only 9.3%. Nasal provocation test using powdered aller-gens was negative in the majority of the subjects of the above group.

In 70% of cases the skin-test conducted on patients with symptoms of allergic rhinitis was positive. Majority of the patients with severe allergic symptoms, strong response in the skin test and marked improvement of the symptoms by hyposensitization with allergen extract were also positive to the nasal provocation test.