The wheals induced by histamine increase with age also in adult patients.

Nils E Eriksson

Purpose. Several factors influence the histamine reactivity. A positive correlation between age and histamine skin reactivity has earlier been shown in children. Earlier studies are, however, conflicting, as far as adult patients are concerned. This study aimed at exploring the influence of age in adult patients on the wheals induced by histamine.

Methods. During the 25 years (1976-2000), we performed skin prick tests (SPT) in clinical routine work on 14723 patients, mainly adults with asthma or rhinitis. As a positive control we used histamine HCl with a concentration of 1 g/lit., 3 g/lit or 10 g/lit. The mean of the longest and the shortest diameters was used in the calculations. Patients with a mean diameter less than 1 mm (n=123) were omitted from the calculations

Results. There was no significant difference between atopic patients (patients having positive SPT with common inhalant allergens) and non atopic patients. Nor were there any significant correlations between histamine diameters and atopy degree (the sum of plusses obtained with seven common inhalant allergens) or the number of allergens showing positive SPT results. Males, however, had larger wheals than females. With all the histamine concentrations used, an increase of wheal diameter with the patients´ ages were seen. The figure shows the wheal diameters related to age groups for tests performed with histamine 10 g/lit.

Conclusion.. There is an increase of wheal size with age all age groups. Since the histamine skin reactivity will influence the size of allergen-induced wheals, the patient’s age should be taken into account, when evaluating SPT results with allergens. The method of evaluating SPT results, often used in Nordic countries, where the allergen induced wheals size is expressed in relation to the size of the histamine-induced wheal, is one way of taking into account the skin histamine sensitivity

 

Diameters in various age groups, means and Standard Error of Means (SEM)

Age group (years)

10 g/lit

3 g/lit

1 g/lit

 

Mean

SEM

Mean

SEM

Mean

SEM

15-20

5.48

0.05

4.61

0.08

4.08

0.04

21-30

5.50

0.04

4.72

0.07

4.27

0.04

31-40

5.69

0.05

5.06

0.08

4.32

0.05

41-50

5.96

0.06

4.83

0.10

4.47

0.06

51-60

6.26

0.08

5.29

0.18

4.66

0.07

> 60 yrs

6.31

0.10

5.55

0.20

4.81

0.10

Total

5.75

0.02

4.88

0.04

4.32

0.02

 


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