Document 0097
 DOCN  M95A0097
 TI    Selection of skin test antigens to evaluate PPD anergy.
 DT    9510
 AU    Wright PW; Crutcher JE; Holiday DB; Department of Family Practice,
       University of Texas Health Center; at Tyler 75710, USA.
 SO    J Fam Pract. 1995 Jul;41(1):59-64. Unique Identifier : AIDSLINE
       MED/95318692
 AB    BACKGROUND. A purified protein derivative (PPD) tuberculin skin test may
       be nonreactive because of cutaneous anergy, technical problems with the
       test, or absence of tuberculosis infection. This study investigated the
       sensitivity and specificity of five test agents in measuring cutaneous
       anergy when the PPD test is nonreactive. Agents evaluated include
       antigens for Candida, mumps, histoplasmin, tetanus, and Trichophyton.
       METHODS. Delayed-type hypersensitivity skin test records were analyzed
       in 1113 patients admitted to the University of Texas Health Center at
       Tyler from December 1988 through June 1993. These patients were admitted
       with initial diagnoses of diseases other than active tuberculosis or
       human immunodeficiency virus infection. RESULTS. Patients with a
       negative PPD test reacted most often to the control skin test Candida
       (63.5%), followed by mumps (52.2%), histoplasmosis (37.2%), tetanus
       (35.7%), and Trichophyton (6.1%). Analysis of these data indicates that
       the use of more than three of the four most commonly reactive control
       tests (Candida, mumps, and histoplasmin or tetanus) yielded minimal
       additional precision in the determination of skin test anergy compared
       with using all five control skin tests. This finding remained constant
       whether the PPD was considered negative at < 5 mm, < 10 mm, or < 15 mm
       of induration. CONCLUSIONS. In controlling for false-negative PPD tests,
       the use of three skin test antigens, Candida, mumps, and tetanus, should
       provide reliable control for delayed-type hypersensitivity anergy.
 DE    Animal  Antigens/*IMMUNOLOGY  Candida/IMMUNOLOGY  *Clonal Anergy
       Evaluation Studies  False Negative Reactions  Hamsters  Human
       Hypersensitivity, Delayed/IMMUNOLOGY  HIV Infections/IMMUNOLOGY  Mumps
       Virus/IMMUNOLOGY  Sensitivity and Specificity  Skin Tests  Tetanus
       Toxoid/IMMUNOLOGY  Tuberculin/*IMMUNOLOGY  *Tuberculin Test
       Tuberculosis, Pulmonary/*DIAGNOSIS/IMMUNOLOGY  JOURNAL ARTICLE

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