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A Study on oral Spanich Provocation Test.

Journal of the Korean Pediatric Society 1983;26(11):1055-1062.
Published online November 30, 1983.
A Study on oral Spanich Provocation Test.
Yu Young Chang, Ki Young Lee
Department of Pediatrics, Yonsei University, College of Medicine
천식환아의 시금치 경구유발시험에 대한 임상적 고찰
장 유 영, 이 기 영
연세대학교 의과대학 소아과학교실
Abstract
In asthmatic children, there were many cases who showed positive reactions to food allergens in allergy skin test. But food itself is not usually the cause of asthma, differing from inhalant allergen. Spinach was the third most common positive skin test with 47.8 percent following house dust and house dust mite in our studies of 205 asthmatics who had visited the allergy clinic of Severance hospital from 1980 to 1982. Oral provocation tests were performed in order to verify that spinach provoked asthma.
Results
were as follows; 1) Ninety-eight spinach positive responders showed an allergy of 4.5 positive allergens including spinach. One hundred and seven negative responders showed on average of 2.5 positive allergens. 2) Twenty-four out of 35(68.8%) showed negative reaction to spinach pollen. This means that a reaction to spinach was caused by spinach rather than spinach pollen. 3) During the first provocation, eight out 35 showed allergic manifestations. Cough with wheezing was the most common manifestation with five cases. Dyspnea, urticaria and profuse nasal discharge followed. During the second provocation, three were positive of the 8 previous responders and only 1(2.9%) responded positively to serial provocations. 4) Total serum eosinophil count before and after the provocations were 485.37/mm3 and 518.83/mm3. There was no statistical significance (p>0.05). 5) Six cases out of 35(17. l%)and PEFR values decreased more than 15%. Spinach is not a significant causative allergen in asthma. When hyposensitization has no effect using known allergens, a provocation test may be needed to identify the true causative agents. In such cases, after careful provocation, one should be decided whether the suspected food should be ingested or not.
Key Words: Oral Spinach Provocation Test, Allergy Skin Test.


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