The information in this website is intended only for healthcare professionals. By entering this site, you are confirming that you are a healthcare professional.
The information in this website is intended only for laboratory professionals. By entering this site, you are confirming that you are a laboratory professional.
David, a 20-year-old university student based in Manchester, presents to his GP in mid-July with a 3-month history of rhinorrhoea, nasal congestion, itching, and sneezing. He also has sore, red, and itchy eyes, and has been sleeping poorly. When questioned about his mood, David confesses that he is very worried about his upcoming exams, and how his health may affect his performance.
Find out how the primary sensitisation was identified with the aid of a simple blood test.
David was previously diagnosed with seasonal allergic rhinitis at the age of 16. He first noticed his symptoms in May, and they were at their worst in July. At the age of 18, he was diagnosed with mild depression.
Whilst talking to David, his GP noticed that he had nasal speech, and was frequently sniffing and rubbing his nose. Allergic shiners were observed upon close inspection of his face, and internal examination of his nose revealed turbinate hypertrophy.
Examination and auscultation of David’s chest revealed no obvious abnormalities or stigmata of asthma.
Manifestations of rhinitis, which are particularly suggestive of allergy, are:1
David’s GP decided to request a specific IgE blood test; SPTs are contraindicated in patients who have recently taken antihistamines, and David did not wish to discontinue his medication.1 The panel of allergens was selected based on David’s symptoms, age, and local sensitisation patterns. As his symptoms usually begin in May and are at their worst in July, a range of allergens that typically present in spring/summer (including pollens and a fungus), were selected for testing.
Specific IgE blood test results could guide the GP’s management of David in various ways, including:2,3
†Refer to specialists/allergists for allergen immunotherapy, if required.
The results showed a significant IgE response to Timothy grass, confirming the previous diagnosis of seasonal allergic rhinitis. No other sensitisations were found, so allergies to birch pollen, ragweed, mugwort, and Alternaria alternata can be ruled out.
As Timothy grass is an outdoor allergen, it cannot be completely avoided.4 However, David could use the following techniques to help limit his exposure:5
Information gained from specific IgE blood tests can be an important factor in deciding on the best pharmacotherapy. For example, commencing therapy just before the start of the local grass pollen season could maximise treatment effectiveness for David.2
Allergen immunotherapy (AIT) is the only potentially disease-modifying option for the treatment of allergies,6 and is usually initiated by allergy specialists.7 Appropriate AIT can prevent the development of asthma8 and, in patients with comorbid asthma, improve symptom control.9 David’s GP decided to refer him to an allergy specialist for selection of AIT.
*The following products are included in the ImmunoCAP™ blood test range:
- ImmunoCAP Allergen g6, Timothy
- ImmunoCAP Allergen t3, Common silver birch
- ImmunoCAP Allergen w1, Common ragweed
- ImmunoCAP Allergen w6, Mugwort
- ImmunoCAP Allergen m6, Alternaria alternata
IgE : immunoglobulin E; kUA/L: allergen-specific kilo units per litre
The people, places, and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.