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When a patient’s symptoms and clinical presentation offers a wide range of diagnostic possibilities, such as an IgE-mediated allergy or an autoimmune disease, test results can be a valuable tool in helping confirm the diagnosis. Together with the case history, serological testing can help you bring clarity to an uncertain diagnosis and provide clear results that are easy to interpret and explain to patients.
Why Testing Is Important
Diagnosis based solely on physical examination, clinical observation, and patient history may result in an inaccurate or incomplete diagnosis. But adding diagnostic testing to aid in a differential diagnosis has been shown to increase confidence in diagnosis to 90 percent.1,2
Diagnostic testing can also help to improve the patient’s quality of life and productivity, reduce costs associated with absenteeism, optimize use of medication, in addition to decreasing unscheduled healthcare visits and lower medication costs.3-5
IgE antibodies appear in human serum and plasma as a result of sensitization to a specific allergen. While clinical presentation and patient history may offer numerous possible causes of symptoms, diagnostic testing can narrow those possibilities and improve confidence in a diagnosis,1,2 enabling you to provide treatment tailored to your patient’s individual needs.
Measurement of circulating IgE antibodies provides an objective assessment of sensitization to an allergen. In general, low IgE antibody levels indicate a low probability of clinical disease, whereas high antibody levels to an allergen show good correlation with clinical disease.8
A standard blood test is convenient—and can test your patients for more than 550 whole allergens and mixes, such as weeds, trees, grasses, pollen, food, and animal dander. Tests are simple to perform, and can be done irrespective of age, skin condition, antihistamine use, or pregnancy.9-12
IgE antibody concentration (kUA/l)
The stability or lability of the protein, and the amount of it contained within the allergen source, are two highly important contributing factors.
Stability: Protein families of components present in plants are ranked by their stability. The degree of stability is shared within a protein family. For instance, the families of storage proteins are very stable proteins. Proteins within the profilin and PR-10 families on the other hand, are more labile proteins.15
Lability: Labile proteins are easily broken down by processing, cooking or by enzymes in the saliva or gut, and will therefore primarily give rise to local reactions when ingested. Stable proteins, on the other hand, will reach the circulation in a more or less intact form and therefore potentially give rise to systemic reactions.15
Cross-reactive proteins are more widely distributed and may be shared between a very wide range of allergen sources. Understanding cross-reactions between species can help you to understand multiple sensitizations, for example, those seen in pollen food allergy syndrome (PFAS).
There are more than 120 types of autoimmune diseases,19 and some have similar symptoms. Inflammation is the most common trait, but presentation can vary widely from one condition to another, and even within the same disease. Because these conditions tend to affect multiple systems, their symptoms can be misleading, which slows down the process towards an accurate diagnosis.