Clinical History-Driven Diagnosis of Allergic Diseases: Utilizing in vitro IgE Testing

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Abstract

This case illustrates the importance of a thorough clinical history in providing an interpretation of previously collected IgE antibody serology as part of a workup for allergic disease. Although a yellow-jacket sting was the allergenic insult that led the patient to the emergency department, nonindicated IgE antibody serology tests were ordered that subsequently required interpretation. This report systematically evaluates the relative significance of previously measured IgE antibody serology responses to 4 major allergen groups (inhalants [aeroallergens], foods, venoms, and drugs) within the context of the patient's history. An algorithm that takes into account the pretest likelihood of disease and diagnostic sensitivity and specificity of the available IgE antibody tests is proposed for decisions about further IgE testing. This case study concludes that selection of testing methods, extract and molecular allergen specificities, and the final interpretation of the results from tests of sensitization such as serological (in vitro) IgE antibody assays requires knowledge of test parameters and clinical judgments based largely on a carefully collected clinical history and physical examination.

Original languageEnglish (US)
Pages (from-to)871-876
Number of pages6
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume3
Issue number6
DOIs
StatePublished - Nov 2015

Keywords

  • Aeroallergens
  • Allergic disease
  • Clinical history
  • Component
  • Drug allergy
  • Food allergy
  • Hymenoptera venom
  • IgE antibody
  • In vitro IgE assays
  • Molecular allergens
  • Total IgE

ASJC Scopus subject areas

  • Immunology and Allergy

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