THESIS: J. A. Ayres submitted this dissertation for the degree of Master of Science, publicly examined at the Department of Tropical Diseases of the School of Medicine of Botucatu, São Paulo State University, Botucatu, São Paulo, Brazil, in September 1997.
Advisors: Professor Benedito Barraviera
ABSTRACT. The present study which was carried out at the University Hospital of the School of Medicine of Botucatu, São Paulo State University (UNESP) aimed to evaluate the intradermal and puncture tests for skin sensitivity in patients submitted to heterologous serotherapy.
Heterologous serum and diagnostic solution extracted from horses (Merck Laboratory) were used as antigens.
Sixty-four patients, 48 males and 16 females, aged 12 to 77 years old were evaluated. Two groups were formed as follows: Group 1 was composed of 27 patients who were administered intramuscularly 50 mg of antihistamine (promethazine). Of the 27 patients, 13 received bothropic antivenom, 6 received antirabies serum, 5 received antitetanic serum and 3 received crotalic antivenom. Group 2 was composed of 37 patients who had not had any previous treatment. Of the 37 patients, 29 received antirabies serum, 4 received antitetanic serum, 2 received bothropic antivenom, 1 received crotalic antivenom and 1 received scorpion antivenom
All the patients were submitted to heterologous serotherapy following recommendation found in medical literature.
The results obtained allowed us to conclude the following:
- The intradermal test performed with pure heterologous serum showed a more severe reaction than that of the test performed with heterologous serum diluted at 1:10. This was observed both 15 and 30 minutes after the test.
- Antigenic concentration might have influenced the final reaction. Thus, the test performed with pure heterologous serum was always higher than that performed with diluted heterologous serum.
- The reading 30 minutes after the test was always higher than that 15 minutes after the test. We might suggest that the reading after 30 minutes is the most appropriate.
- No systemic reaction was observed while the tests were carried out.
- Administration of antihistamine (promethazine) as a prophylactic medication did not protect the patients against the early reactions during antivenom therapy.
- The tests conducted 30 days later showed a higher reactivity, probably due to sensitization with a type TH2 immune response.
- The puncture test using diagnostic serum extracted from horses was not effective in the detection of sensitive individuals.
- The intradermal test did not allow us to predict early reaction.
CORRESPONDENCE TO:
J. A. AYRES - Curso de Enfermagem, Faculdade de Medicina de Botucatu, Distrito de Rubião Junior, s/n, CEP 18.618-000, Botucatu, SP, Brasil.
Publication Dates
-
Publication in this collection
26 Nov 1998 -
Date of issue
1998
