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Chronic Otitis Media

In chronic otitis media, a comprehensive diagnosis, including the identification of underlying allergic triggers, can help you produce the most effective treatment plan. One-third to half of patients with otitis media with effusion (OME) have underlying allergic disease.1,2 Healthcare professionals can utilize specific IgE testing to enhance the diagnostic process and pinpoint those allergens. It is recommended that an allergy- focused patient history and physical examination is conducted in patients with chronic otitis media.3,4

Guided by the allergy-focused patient history, the next step should be testing for allergic sensitizations. When added to an allergy-focused patient history, the use of specific IgE tests, skin-prick tests (SPT), or both increases your diagnostic certainty by ruling in or ruling out allergies.5,6

  

 

 

KEY ALLERGY TEST DIFFERENCES
Specific IgE blood testing
Skin prick testing
Typically ordered and reviewed by a clinician
YES
YES
Patients do not need to discontinue allergy medications
YES
NO
Requires only one needle stick (a single blood sample)
YES
NO
Carries no risk of severe allergic reaction
YES
NO
Can be used when extensive skin rash is present
YES
NO
Component testing is available
YES
NO
Same day results in the office
NO
YES

 

 

Common allergens to test for:1

Asthma Symptoms

Pollen

Asthma Symptoms

House Dust Mite

Asthma Symptoms

Animal Dander

Asthma Symptoms

Milk

Asthma Symptoms

Molds

Asthma Symptoms

Cockroach

Asthma Symptoms

Egg

Help Identify the Allergen(s) That Add Up to Symptoms

Just as diagnostic testing is routine for diagnosis of diseases such as type 2 diabetes and dyslipidemia, specific IgE serological tests aid in the diagnosis of allergic disease. As such, anyone presenting with chronic otitis media or other allergy symptoms is a candidate for specific IgE testing.

Suspicion of allergy: Allergy-like symptoms + Case history

Confirm/Identify Relevant allergens: ImmunoCAP Complete Allergen testing with relevant allergens*

0.1 kUA/l ---------------------------------------------> 100

Risk of symptomatic allergy increases with increase in lgE anti-body level. 21,22

Test interpretation:

Negative (<0.1 kUA/l***): Symptoms are probably not caused by lgE mediated allergy. Test results should be considered in conjunction with the case history.***





Patient Management:

Positive (≥0.1 kUA/l**): Symptoms are probably caused by lgE mediated allergy. Test results should be considered in conjunction with the case history***
 

*Symptom profile containing relevant allergens. Local adaptation with respect to age and regional differences is recommended.

** The lgE antibody level should be regarded as additional information helping the clinician confirm the clinical decision, based also on a case history and physical examination.

*** Factors to consider for a final diagnosis: age, degree of atopy, allergen load, type of sensitizing allergens previous symptoms, other triggering factors.

Allergen Testing

ImmunoCAPTM Whole Allergen

ImmunoCAP Whole Allergen testing provides an objective measurement of the circulating IgE antibodies and the sensitization to a specific whole allergen. Specific IgE antibodies can appear as a result of exposure to an allergen in atopic individuals. ImmunoCAP Whole Allergen measure IgE antibodies to specific allergens in human serum or plasma and allows quantitative measurements of a wide range of individual allergens and allergen components. Over 550 different allergens are available for determinations.7


 

ImmunoCAPTM Allergen Components

ImmunoCAP Allergen Components measure specific IgE antibodies to individual molecular allergens, in either serum or plasma. These allergens, which are purified, native or recombinant proteins, offer the unique opportunity to assess a person’s allergic sensitization pattern at the molecular level. Different component groups often elicit different types of reactions, so testing them can indicate if a patient’s prior symptoms or positive test results were caused by allergy to a given substance or by a cross-reaction with another allergen. Component testing can also help identify patients who may be good candidates for supervised oral food challenges. Over 100 different ImmunoCAP Allergen Components are available for determinations.7

    

Why Test for Allergies

There are several valid reasons why a specific IgE serological test should be considered if your patient is experiencing any symptoms. Allergic disease and eustachian tube dysfunction:1,10

  • Increase inflammation
  • Increase serous fluid production
  • Provide a rich environment for infection
Allergy Testing

Conditions & Diseases

Understand allergic and autoimmune diseases.
 

References
  1. Zernotti ME, et al. Otitis media with effusion and atopy: is there a causal relationship? World Allergy Organ J. 2017; 10(1):37  
  2. Kwon C, et al. Allergic diseases in children with otitis media with effusion. Int J. Pediatr Otorhinolaryngol. 2013;77(2):158-161.  
  3. Pawankar R, at el. World Allergy Organization. White Book on Allergy (WAO). 2011. http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf. Accessed December 2017.  
  4. Eigenmann PA, et al. Testing children for allergies: why, how, who and when: an updated statement of the European Academy of Allergy and Clinical Immunology (EAACI) Section on Pediatrics and the EAACI-Clemens von Pirquet Foundation. Pediatr Allergy Immunol. 2013;24:195-209.  
  5. 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.  
  6. 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.  
  7. Phadia™ ImmunoCAP™ Specific IgE Directions for Use for the Phadia 250 Laboratory System. Issued September 2017.
  8. Yunginger JW, et al. Quantitative IgE antibody assays in allergic diseases. J Allergy Clin Immunol. 2000;105(6pt1):1077-1084.  
  9. Zethraeus N, et al. Health-care cost reduction resulting from primary-care allergy testing in children in Italy. Ital J Pediatr. 2010;36:61.  
  10. Fireman P. Otitis media and eustachian tube dysfunction: Connection to allergic rhinitis. J Allergy Clin Immunol. 1997;99:s787-97