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Intradermal allergy test in psittacines: unreliable with and without intravenous fluorescein
Bayer 1688.jpg Picture © Bayer Animal Health
The intradermal skin test is thought to be the `gold standard` in the diagnosis of atopic dermatitis. Unfortunately, the results often are not easy to read, especially in cats. So some years ago the technique was modified: fluorescein was given intravenously prior to the test to stain the positive results. An american group tried the same technique in psittacines...

Twenty-five healthy, anaesthetized Hispaniolan Amazon parrots (Amazona ventralis) were injected intravenously with 10 mg kg1 fluorescein-sodium 1% followed by intradermal injections of 0.02 mL phosphate-buffered saline, histamine phosphate (1:100 000 w/v) and codeine phosphate (1:100 000 w/v) at the sternal apteria. Wheal diameters of reaction sites were measured grossly and under illumination with a Wood`s lamp after 5 and 10 min.
Fluorescence-enhanced injection sites were scored between 0 and 2, with 0 equivalent to normal skin and 2 equivalent to a plucked feather follicle. The presence of a fluorescent halo around intradermal injections was also recorded.

Under Wood`s light illumination at 10 min, histamine and saline were evaluated as positive and negative controls, respectively, based on a positive test having a halo and a score of 2.

Sensitivity and specificity were each 76% for halo, 84 and 42% for score and 64 and 77% for combination of score and halo, respectively. Further, mean histamine reactions were significantly larger than codeine phosphate and saline (8.8 ± 0.4 mm; 7.2 ± 0.3 mm; 5.9 ± 0.6 mm); however, this finding was not consistent in individual birds. Wheal size, halo presence and score were affected by site location independent from the injected compound.

Intravenous fluorescein improved the readability of avian skin tests; however, the compounds tested raised inconsistent reactions in wheal size, score or halo presence. The compound-independent site effect raises concern on the validity of avian skin testing and warrants investigation of other techniques such as in vitro allergy testing.

Based on our findings, intradermal allergy testing in psittacines with or without fluorescein is unreliable and cannot be recommended for practical clinical use.

Source: Nett, Claudia S., Hosgood, Giselle, Heatley, J. Jill, Foil, Carol S. & Tully, Thomas N. (2003): Evaluation of intravenous fluorescein in intradermal allergy testing in psittacines. In: Veterinary Dermatology 14 (6), 323-332.




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