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Allergic Conditions 

By definition, an allergy is a hypersensitivity immune response to normally harmless substances, such as pollens or foods. For most people, these substances–also called allergens–pose no problem. In allergic individuals, however, the immune system identifies them as a threat and produces an inappropriate response.1

The symptoms of allergic diseases are numerous and may also be attributable to more than one allergy, as up to 80% of allergic patients are sensitized to more than one allergen.2

Identifying your patient’s allergic triggers can help:

  • Control allergic asthma and allergic rhinitis
  • Prevent the use of avoidable medications and avoidable visits to your office
  • Optimize care and manage important health risks
  • Reduce costs associated with absenteeism and lost productivity at work and school

Diagnostic testing is already routine

The identification and management of allergies can be summarized a similar process to that of other diseases you may already be managing:

History and examination

1. History and examination

As with all medical conundrums, the first step is a focused history and physical examination.

  

Testing

2. Test to identify IgE sensitization

The second step is identifying sensitizing allergens and their sources—this step is critical to the diagnosis and clinical management of allergies. Used routinely to aid in the diagnosis of allergies, specific IgE testing is an objective tool that yields quantifiable results you can also use in the management of your patient’s allergies.3,4 Specific IgE testing is a logical addition to your testing array because it fits into the workup in a similar manner, as the assays you may regularly order for managing diabetes or hypercholesterolemia.

  

targeted management

3. Targeted management

The third step is targeted management. By confirming the patient’s unique triggers, your management approach, which may include pharmacological and non-pharmacological options, can be targeted to manage the patient's unique pattern of triggers and associated symptoms.3,4


As with all medical conundrums, the first step is a focused history and physical examination. In possible allergic diseases, the second step is identifying sensitizing allergens and their sources—this step is critical to the diagnosis of allergen sensitivities.3

Specific IgE testing is a logical addition to your testing array because it fits into the workup in a similar manner, as the assays you may regularly order for managing diabetes or hypercholesterolemia.
 

Type 2 Diabetes
Dyslipidemia
Allergy & Asthma
Hx & PE
Hx & PE
Hx & PE
lab tests
lipid profile

lgE profile

diet and exercise diet and exercise
targeted exposure reduction
pharmacotherapy
pharmacotherapy
pharmacotherapy


The third step is management. The mainstay of management in allergic conditions is exposure reduction, and/or avoidance, thereby reducing the causative factor behind symptoms.3


Guided by the allergy-focused patient history and physical exam, the most appropriate next step may be to conduct testing for allergic sensitization. Skin prick testing and specific IgE measurements can help you rule in or rule out specific allergen sensitizations, which may give you the ability to correctly diagnose and improve clinical management.4,5

How to order a test

How to Order a Test

If you have a clinical suspicion of allergic involvement, specific IgE testing can be requested via your local laboratory ordering system. The test is already available – it may be listed as specific IgE, RAST, SpIgE, sIgE, ImmunoCAPTM. You may need to specify the allergen/s you require for the test and provide a brief patient history.

References
  1. Galli SJ, Tsai M, Piliponsky AM. The development of allergic inflammation. Nature. 2008;454(7203):445-454. doi:10.1038/nature07204.
  2. Ciprandi G, Alesina R, Ariano R, et al. Characteristics of patients with allergic polysensitization: the POLISMAIL study. Eur Ann Allergy Clin Immunol. 2008;40(3):77-83
  3. House of Lords. Science and Technology sixth report- the extent and burden of allergy in the United Kingdom. http://www.bsaci.org/pdf/HoL_science_report_vol.1.pdf. Accessed December 2017.
  4. Duran-Tauleria E, Vignati G, Guedan MJ, et al. The utility of specific immunoglobulin E measurements in primary care. Allergy. 2004;59 (Suppl 78):35-41.
  5. Niggemann B, Nilsson M, Friedrichs F. Paediatric allergy diagnosis in primary care is improved by invitro allergen specific IgE testing. Pediatr Allergy Immunol. 2008;19:325-331.