Atopic Disease As A Prediction Of Metal Hypersensitivity In Pectus Excavatum Patients

Previous studies estimate metal hypersensitivity prevalence of 2.2% among pectus excavatum patients. The atopic characteristics of these patients are poorly understood overall and as a method of screening for metal hypersensitivity. We aim to characterize the prevalence of atopic disorders of these patients and assess if the presence of atopy is helpful in predicting metal hypersensitivity. A retrospective cohort study of 71 consecutive preoperative metal patch tested patients with pectus excavatum was conducted at a single academic hospital from 01/01/2012 to 07/30/2017. Patch testing results, family history, and personal history of atopic diseases (including allergic rhinoconjunctivitis, food allergies, drug allergy, urticaria, angioedema, hymenoptera reaction, atopic dermatitis, and asthma) were recorded. Data were categorized into two by two contingency tables and analyzed by Fisher's exact test. Among 71 pectus excavatum patients, 93% were male with a mean age of 17.9 ± 2.2 years. Thirty-three patients (47%) had atopy and 36 patients (51%) had a family history of atopic diseases. Allergic rhinoconjunctivitis had the highest prevalence, 79% by personal history and 69% by family history. Neither personal history of atopy (p=0.22), nor a family history of atopy (p=0.35) predicted patch test results. Patients with pectus excavatum have a high prevalence of personal and family history of atopic diseases but, neither predicts patch test results. Perioperative patch testing remains the best screening method for metal hypersensitivity in these patients.