Delayed hypersensitivity skin testing in nutritional assessment. 1987

B S Linn
Veterans Administration Medical Center, Miami, Florida 33125.

Skin testing is useful in nutritional assessment because decreased immunity is associated with malnutrition. Absence of positive reactions indicates anergy, reaction to one test shows some decreased immunity, and response to two or more tests is considered normal. Variation in number and type of test antigens could lead to contradictory results. Also, conventional intradermal injections vary in antigen strengths, injection techniques, and subjective evaluations, and are also uncomfortable. This study compared results from three, four, or seven antigens in relation to other nutritional indices. Fifty hospitalized men with cancer were assessed with a 23 item Protein Energy Malnutrition Scale and classified as well nourished (60%) or malnourished (40%). Number of tests did not differ in identifying the malnourished; however, the smaller battery misclassified the normal as malnourished twice as often as the seven tests. Misclassification of normal as abnormal could lead to unnecessary interventions, such as total parenteral nutrition, that increase complications and cost of care dramatically.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D007111 Immunity, Cellular Manifestations of the immune response which are mediated by antigen-sensitized T-lymphocytes via lymphokines or direct cytotoxicity. This takes place in the absence of circulating antibody or where antibody plays a subordinate role. Cell-Mediated Immunity,Cellular Immune Response,Cell Mediated Immunity,Cell-Mediated Immunities,Cellular Immune Responses,Cellular Immunities,Cellular Immunity,Immune Response, Cellular,Immune Responses, Cellular,Immunities, Cell-Mediated,Immunities, Cellular,Immunity, Cell-Mediated,Response, Cellular Immune
D007428 Intradermal Tests Skin tests in which the sensitizer is injected. Passive Transfer Test,Prausnitz-Kustner Test,Intradermal Test,Passive Transfer Tests,Prausnitz Kustner Test,Test, Intradermal,Test, Passive Transfer,Test, Prausnitz-Kustner,Tests, Intradermal,Tests, Passive Transfer
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009752 Nutritional Status State of the body in relation to the consumption and utilization of nutrients. Nutrition Status,Status, Nutrition,Status, Nutritional
D011502 Protein-Energy Malnutrition The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses. Marasmus,Protein-Calorie Malnutrition,Malnutrition, Protein-Calorie,Malnutrition, Protein-Energy,Malnutritions, Protein-Energy,Protein Calorie Malnutrition,Protein Energy Malnutrition
D005188 False Negative Reactions Negative test results in subjects who possess the attribute for which the test is conducted. The labeling of diseased persons as healthy when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed) False Negative Reaction,Reaction, False Negative,Reactions, False Negative
D005189 False Positive Reactions Positive test results in subjects who do not possess the attribute for which the test is conducted. The labeling of healthy persons as diseased when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed) False Positive Reaction,Positive Reaction, False,Positive Reactions, False,Reaction, False Positive,Reactions, False Positive
D006258 Head and Neck Neoplasms Soft tissue tumors or cancer arising from the mucosal surfaces of the LIP; oral cavity; PHARYNX; LARYNX; and cervical esophagus. Other sites included are the NOSE and PARANASAL SINUSES; SALIVARY GLANDS; THYROID GLAND and PARATHYROID GLANDS; and MELANOMA and non-melanoma skin cancers of the head and neck. (from Holland et al., Cancer Medicine, 4th ed, p1651) Cancer of Head and Neck,Head Cancer,Head Neoplasm,Head and Neck Cancer,Head and Neck Neoplasm,Neck Cancer,Neck Neoplasm,Neck Neoplasms,Neoplasms, Upper Aerodigestive Tract,UADT Neoplasm,Upper Aerodigestive Tract Neoplasm,Upper Aerodigestive Tract Neoplasms,Cancer of Head,Cancer of Neck,Cancer of the Head,Cancer of the Head and Neck,Cancer of the Neck,Head Neoplasms,Head, Neck Neoplasms,Neoplasms, Head,Neoplasms, Head and Neck,Neoplasms, Neck,UADT Neoplasms,Cancer, Head,Cancer, Neck,Cancers, Head,Cancers, Neck,Head Cancers,Neck Cancers,Neoplasm, Head,Neoplasm, Neck,Neoplasm, UADT,Neoplasms, UADT

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