RAST test

The basis for this anaphylactic reaction was hypersensitivity to Echinacea, confirmed by skin prick and RAST testing. However, others have challenged the notion of a causal relation in this case (28). Nevertheless, the author affirmed his belief that Echinacea was the causal agent and reported that at that time Echinacea accounted for 22 of 266 suspected adverse reactions to complementary medicines reported to the Australian Adverse Drug Reaction Advisory Committee (28). 

A 50-year-old Romanian man was advised by his herbalist to treat his asthma with a compress of freshly crushed garlic (9). He wore the compress on his forehead overnight and subsequently developed second-degree burns in this area. Specific IgE RAST tests for... 

Of 28 workers in a pharmaceutical factory that produced morphine and other alkaloids extracted from the shells of P. somniferum, six had symptoms of sensitization and positive skin tests (10). A bronchial provocation test was positive in four of them, and in all six there was a specific IgE, detected by ELISA and RAST tests using an aqueous extract of P. somniferum. 

A 22-year-old woman had labial urticaria with orophar-jmgeal edema some minutes after kissing her boyfriend, who had taken amoxicUhn some minutes before kissing her (150). A few months before, she had had generalized urticaria several minutes after taking amoxicillin. A prick test with amoxicUhn was positive and a similar test with peniciUm G was negative. Total serum IgE was 90 kU/1 and a RAST test for amoxicillin was positive (4.74 kU/1). 

A maximum of 20% of subjects with a history of allergylike reactions after administration of a penicillin antibiotic have positive skin or RAST tests (165-167). Tests using benzylpenicillin derivatives or semisynthetic penicillins can almost double positive test results (168,169). Patients with a positive history but negative skin tests run a 1-3% risk of an IgE-mediated reaction and 60% of testpositive patients had evidence of an immediate reaction, including urticaria and angioedema (165). 

Among the numerous in vitro tests proposed for diagnosis, two deserve more extensive discussion those designed to detect specific IgE or IgG antibodies (RAST test), and those based on the presence in the blood of specifically sensitized lymphocytes. 

The RAST test has for the time being been applied only to the diagnosis of penicillin allergies (Wide and Juhlin 1971 Kraft et al. 1977 de Weck 1978),... 

Table 4. Comparison of skin tests and RAST test in patients with history of penicillin allergy...

Bartenders can be exposed to plants in a limited number of ways. Citrus peels (lemon, lime, and orange) contain potential allergens [259], and psoralens in lime may produce photosensitivity [259]. Other decorations are possibilities, such as mint, Menthus citrata (aquatica) [260]. There are also reports of allergy to plant materials in stirring instruments. One patient proved to be allergic to a stirrer made of coconut [261]. Contact urticaria to beer was reported in a waitress who was most sensitive to malt on RAST test [262]. 

Six bakers with hand eczema all demonstrated positive use tests and positive RAST tests to dough, and all developed contact dermatitis upon contact with flour. The reaction pattern was likened to an atopic state (Pigatto et al. 1987). 

Both the prick test and the RAST test were positive to fungal but not to bacterial ot-amylase in a baker with rhino conjunctivitis and urticaria from flour (Kanerva et al. 1997). Urticarial lesions on the hands of a baker were associated with immediate-type hypersensitivity to balsam of Peru, cinnamic aldehyde and benzalde-hyde. The lesions disappeared when he wore gloves at work (Seite-Bellezza et al. 1994). 

Flour mites were described as a cause of papular dermatoses on the backs of the hands of two bakers (Fisher 1982). Flour and storage mites can aggravate atopic dermatitis (Giihring 1989). Among farmers, the most common positive RAST tests were to house-dust... 

Further reading Editorial. (1976). The RAST test. Lancet, 1, 1061... 

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