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Positive pathergy test

MedGen UID:
1391420
•Concept ID:
C4476836
•
Finding
HPO: HP:0025532

Definition

With the pathergy test, a small, sterile needle is inserted into the skin of the forearm. The site of injectionis circuled and observed after one and two days. If a small red bump or pustule at the site of needle insertion occurs, the pathergy test is considered to have a positive (abnormal) result. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPositive pathergy test

Professional guidelines

PubMed

Impact of the positive pathergy test on the performance of classification/diagnosis criteria for Behcet's disease.
Davatchi F, Sadeghi Abdollahi B, Chams-Davatchi C, Shahram F, Ghodsi Z, Nadji A, Akhlaghi M, Faezi T, Shams H, Larimi R, Ashofteh F
Mod Rheumatol 2013 Jan;23(1):125-32. Epub 2012 Apr 4 doi: 10.1007/s10165-012-0626-9. PMID: 22476858
Relationships of HLA-B51 or B5 genotype with Behcet's disease clinical characteristics: systematic review and meta-analyses of observational studies.
Maldini C, Lavalley MP, Cheminant M, de Menthon M, Mahr A
Rheumatology (Oxford) 2012 May;51(5):887-900. Epub 2012 Jan 11 doi: 10.1093/rheumatology/ker428. PMID: 22240504
Behçet disease: clinical features and management in a Brazilian tertiary hospital.
Oliveira AC, Buosi AL, Dutra LA, de Souza AW
J Clin Rheumatol 2011 Dec;17(8):416-20. doi: 10.1097/RHU.0b013e31823a46ed. PMID: 22089985

Recent clinical studies

Etiology

The diagnostic role of pathergy test in patients with Behçet's disease from the Western Europe.
Vitale A, Berlengiero V, Caggiano V, Barneschi S, Mourabi M, Sota J, Gentileschi S, Maggio MC, Gaggiano C, Tarsia M, Tosi GM, Lopalco G, Fabiani C, Frediani B, Cantarini L
Intern Emerg Med 2023 Jan;18(1):77-83. Epub 2022 Dec 21 doi: 10.1007/s11739-022-03117-3. PMID: 36542302
Novel mutation in the NRLP3 manifesting as an intermediate phenotype of cryopyrinopathies.
Paim-Marques LB, Cavalcante A, Castro C, Muskardin TLW, de Oliveira JB, Niewold TB, Appenzeller S
Rheumatol Int 2021 Jan;41(1):219-225. Epub 2020 Aug 19 doi: 10.1007/s00296-020-04683-5. PMID: 32813153
Mucocutaneous manifestations of Behçet's disease.
Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP
Acta Reumatol Port 2013 Apr-Jun;38(2):77-90. PMID: 24141344
Pyoderma gangrenosum: an Indian perspective.
Bhat RM, Nandakishore B, Sequeira FF, Sukumar D, Kamath GH, Martis J, Furtado S
Clin Exp Dermatol 2011 Apr;36(3):242-7. Epub 2010 Nov 10 doi: 10.1111/j.1365-2230.2010.03941.x. PMID: 21070329
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease.
Lancet 1990 May 5;335(8697):1078-80. PMID: 1970380

Diagnosis

Behcet's Disease Diagnosed by Allergy Skin Testing and Positive Pathergy Test.
Yeung WWY, Wong SM, Au EYL, Li PH
J Allergy Clin Immunol Pract 2021 Apr;9(4):1715-1716. Epub 2020 Dec 13 doi: 10.1016/j.jaip.2020.11.029. PMID: 33317952
Mucocutaneous manifestations of Behçet's disease.
Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP
Acta Reumatol Port 2013 Apr-Jun;38(2):77-90. PMID: 24141344
Pyoderma gangrenosum: an Indian perspective.
Bhat RM, Nandakishore B, Sequeira FF, Sukumar D, Kamath GH, Martis J, Furtado S
Clin Exp Dermatol 2011 Apr;36(3):242-7. Epub 2010 Nov 10 doi: 10.1111/j.1365-2230.2010.03941.x. PMID: 21070329
Gastrointestinal manifestations of Behçet's disease.
Ebert EC
Dig Dis Sci 2009 Feb;54(2):201-7. Epub 2008 Jul 2 doi: 10.1007/s10620-008-0337-4. PMID: 18594975
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease.
Lancet 1990 May 5;335(8697):1078-80. PMID: 1970380

Therapy

Novel mutation in the NRLP3 manifesting as an intermediate phenotype of cryopyrinopathies.
Paim-Marques LB, Cavalcante A, Castro C, Muskardin TLW, de Oliveira JB, Niewold TB, Appenzeller S
Rheumatol Int 2021 Jan;41(1):219-225. Epub 2020 Aug 19 doi: 10.1007/s00296-020-04683-5. PMID: 32813153
Pyoderma gangrenosum: an Indian perspective.
Bhat RM, Nandakishore B, Sequeira FF, Sukumar D, Kamath GH, Martis J, Furtado S
Clin Exp Dermatol 2011 Apr;36(3):242-7. Epub 2010 Nov 10 doi: 10.1111/j.1365-2230.2010.03941.x. PMID: 21070329
Late onset Behçet's disease.
Ziadé N, Awada H
Joint Bone Spine 2006 Oct;73(5):567-9. Epub 2006 Jul 14 doi: 10.1016/j.jbspin.2006.06.002. PMID: 16904928
Current therapy in Behcet's disease.
Sakane T, Takeno M
Skin Therapy Lett 2000;5(6):3-5. PMID: 10889570
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease.
Lancet 1990 May 5;335(8697):1078-80. PMID: 1970380

Prognosis

Impact of the positive pathergy test on the performance of classification/diagnosis criteria for Behcet's disease.
Davatchi F, Sadeghi Abdollahi B, Chams-Davatchi C, Shahram F, Ghodsi Z, Nadji A, Akhlaghi M, Faezi T, Shams H, Larimi R, Ashofteh F
Mod Rheumatol 2013 Jan;23(1):125-32. Epub 2012 Apr 4 doi: 10.1007/s10165-012-0626-9. PMID: 22476858
Pyoderma gangrenosum: an Indian perspective.
Bhat RM, Nandakishore B, Sequeira FF, Sukumar D, Kamath GH, Martis J, Furtado S
Clin Exp Dermatol 2011 Apr;36(3):242-7. Epub 2010 Nov 10 doi: 10.1111/j.1365-2230.2010.03941.x. PMID: 21070329
Gastrointestinal manifestations of Behçet's disease.
Ebert EC
Dig Dis Sci 2009 Feb;54(2):201-7. Epub 2008 Jul 2 doi: 10.1007/s10620-008-0337-4. PMID: 18594975
Current therapy in Behcet's disease.
Sakane T, Takeno M
Skin Therapy Lett 2000;5(6):3-5. PMID: 10889570
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease.
Lancet 1990 May 5;335(8697):1078-80. PMID: 1970380

Clinical prediction guides

The diagnostic role of pathergy test in patients with Behçet's disease from the Western Europe.
Vitale A, Berlengiero V, Caggiano V, Barneschi S, Mourabi M, Sota J, Gentileschi S, Maggio MC, Gaggiano C, Tarsia M, Tosi GM, Lopalco G, Fabiani C, Frediani B, Cantarini L
Intern Emerg Med 2023 Jan;18(1):77-83. Epub 2022 Dec 21 doi: 10.1007/s11739-022-03117-3. PMID: 36542302
Natural history of Behçet's disease focusing on remission of oral ulcers.
Tomizuka T, Kikuchi H, Okubo M, Asako K, Miyata S, Kono H
Mod Rheumatol 2023 Apr 13;33(3):566-573. doi: 10.1093/mr/roac035. PMID: 35445275
Novel mutation in the NRLP3 manifesting as an intermediate phenotype of cryopyrinopathies.
Paim-Marques LB, Cavalcante A, Castro C, Muskardin TLW, de Oliveira JB, Niewold TB, Appenzeller S
Rheumatol Int 2021 Jan;41(1):219-225. Epub 2020 Aug 19 doi: 10.1007/s00296-020-04683-5. PMID: 32813153
Impact of the positive pathergy test on the performance of classification/diagnosis criteria for Behcet's disease.
Davatchi F, Sadeghi Abdollahi B, Chams-Davatchi C, Shahram F, Ghodsi Z, Nadji A, Akhlaghi M, Faezi T, Shams H, Larimi R, Ashofteh F
Mod Rheumatol 2013 Jan;23(1):125-32. Epub 2012 Apr 4 doi: 10.1007/s10165-012-0626-9. PMID: 22476858
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease.
Lancet 1990 May 5;335(8697):1078-80. PMID: 1970380

Recent systematic reviews

Relationships of HLA-B51 or B5 genotype with Behcet's disease clinical characteristics: systematic review and meta-analyses of observational studies.
Maldini C, Lavalley MP, Cheminant M, de Menthon M, Mahr A
Rheumatology (Oxford) 2012 May;51(5):887-900. Epub 2012 Jan 11 doi: 10.1093/rheumatology/ker428. PMID: 22240504

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