Abstract
Childhood allergies pose huge economic burden and adverse effects on quality of life. Serum IgE has been considered a surrogate allergy marker for decades. Availability of several over-the-counter allergy tests add to confusion of partially trained caregivers. The present review focuses on current status of allergy testing in Indian scenario. Various in-vitro and in-vivo diagnostic modalities are available for allergy detection. Skin prick tests are useful for aero-allergies whereas oral challenge tests are best for identifying suspected food allergies. An allergy test should be individualized based on clinical features, diagnostic efficacy, and cost-benefit analysis.
Keywords
Challenge test Histamine Hypersensitivity IgE Patch test Skin prick testPreview
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Notes
Funding: None; Competing interest: None stated.
References
- 1.Pawankar R. Allergic diseases and asthma: A global public health concern and a call to action. World Allergy Organ J. 2014;7:12.CrossRefGoogle Scholar
- 2.Antolin-Amerigo D, Manso L, Caminati M, de la Hoz Caballer B, Cerecedo I, Muriel A, et al. Quality of life in patients with food allergy. Clin Mol Allergy. 2016;14:4.CrossRefGoogle Scholar
- 3.Prasad R, Kumar R. Allergy Situation in India: what is being done? Indian J Chest Dis Allied Sci. 2013;55:7–8.PubMedGoogle Scholar
- 4.Chandrika D. Allergic rhinitis in India: an overview. Int J Otorhinolaryngol Head Neck Surg. 2017;3:1–6.CrossRefGoogle Scholar
- 5.Pawankar R, Holgate ST, Canonica GW, Lockey RF. White Book on Allergy. Milwaukee, Winconsin, United State of America. World Allergy Organization (WAO); 2011.Google Scholar
- 6.Igea JM. The history of the idea of allergy. Allergy. 2013;68:966–73.CrossRefGoogle Scholar
- 7.Eastman J, Gupta R, Jose J. Immune Mechanisms. In: Lee G, Stukus D, Yu Joyce, editors. Review for the Allergy & Immunology Boards. 3rd ed. Arlington Heights, United States of America. American College of Allergy, Asthma & Immunology (ACAAI); 2016.p.45–6.Google Scholar
- 8.Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention and management. J Allergy Clin Immunol. 2018;141:41–58.CrossRefGoogle Scholar
- 9.Abraham JT, Barcena MA, Bjelac JA, Pazheri FP. Specific Diagnostic Modalities. In: Lee G, Stukus D, Yu Joyce, editors. Review for the Allergy & Immunology Boards, 3rd ed. Arlington Heights, United States of America. American College of Allergy, Asthma & Immunology (ACAAI); 2016.p.417–500.Google Scholar
- 10.Schimke LF, Sawalle-Belohradsky J, Roesler J, Wollenberg A, Rack A, Borte M, et al. Diagnostic approach to the hyper-IgE syndromes: immunologic and clinical key findings to differentiate hyper-IgE syndromes from atopic dermatitis. J Allergy Clin Immunol. 2010;126:611–7.CrossRefGoogle Scholar
- 11.de Vos G, Nazari R, Ferastraoaru D, Parikh P, Geliebter R, Pichardo Y, et al. Discordance between aeroallergen specific serum IgE and skin testing in children younger than 4 years. Ann Allergy Asthma Immunol. 2013;110:438–43.CrossRefGoogle Scholar
- 12.Treudler R, Simon JC. Overview of component resolved diagnostics. Curr Allergy Asthma Rep. 2013;13:110–7.CrossRefGoogle Scholar
- 13.Borres MP, Maruyama N, Sato S, Ebisawa M. Recent advances in component resolved diagnosis in food allergy. Allergol Int. 2016;65:378–87.CrossRefGoogle Scholar
- 14.Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100: S1-148.CrossRefGoogle Scholar
- 15.Kowalski ML, Ansotegui I, Aberer W, Al-Ahmad M, Akdis M, Ballmer-Weber BK, et al. Risk and Safety Requirements for Diagnostic and Therapeutic Procedures in Allergology: World Allergy Organization Statement. World Allergy Organ J. 2016;9:33.CrossRefGoogle Scholar
- 16.Smith W. Skin Prick Testing for the Diagnosis of Allergic Disease–A Manual for Practitioners. Australasian Society of Clinical Immunology and Allergy (ASCIA). Available from: http://www.allergy.org.au/images/stories/pospapers/ASCIA_SPT_Manual_March_2016.pdf. Accessed September 26, 2019.Google Scholar
- 17.Bhattacharya K. Sircar G, Dasgupta A, Gupta Bhattacharya S. Spectrum of allergens and allergen biology in India. Int Arch Allergy Immunol. 2018;177:219–37.CrossRefGoogle Scholar
- 18.Comberiati P, Cipriani F, Schwarz A, Posa D, Host C, Peroni DG. Diagnosis and treatment of pediatric food allergy: an update. Ital J Pediatr. 2015;41:13.CrossRefGoogle Scholar
- 19.van der Valk JP, Gerth van Wijk R, Hoorn E, Groenendijk L, Groenendijk IM, de Jong NW. Measurement and interpretation of skin prick test results. Clin Transl Allergy. 2016;6:8.CrossRefGoogle Scholar
- 20.Haahtela T, Burbach GJ, Bachert C, Bindslev-Jensen C, Bonini S, Bousquet J, et al. Clinical relevance is associated with allergen-specific wheal size in skin prick testing. Clin Exp Allergy. 2014;44:407–16.CrossRefGoogle Scholar
- 21.Alimuddin S, Rengganis I, Rumende CM, Setiati S. Comparison of specific immunoglobulin E with the skin prick test in the diagnosis of house dust mites and cockroach sensitization in patients with asthma and/or allergic rhinitis. Acta Med Indones. 2018;50:125–31.PubMedGoogle Scholar
- 22.Ferastraoaru D, Shtessel M, Lobell E, Hudes G, Rosenstreich D, ptdeU Vos G. Diagnosing environmental allergies: Comparison of skin-prick, intradermal, and serum specific immunoglobulin E testing. Allergy Rhinol (Providence). 2017;8:53–62.CrossRefGoogle Scholar
- 23.Bourke J, Coulson I, English J. Guidelines for the management of contact dermatitis: an update. Br J Dermatol. 2009;160:946–54.CrossRefGoogle Scholar
- 24.AlSelahi EM, Cooke AJ, Kempe E, Schiffman AB, Sokol K, Virani S. Hypersensitivity disorders. In: Lee G, Stukus D, Yu Joyce, editors. Review for the allergy & immunology boards. 3rd ed. Arlington Heights, United States of America. American College of Allergy, Asthma & Immunology (ACAAI); 2016.p.129–202.Google Scholar
- 25.Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, et al. Food allergy: A practice parameter update-2014. J Allergy Clin Immunol. 2014;134:1016–25.CrossRefGoogle Scholar
- 26.Caffarelli C, Baldi F, Bendandi B, Calzone L, Marani M, Pasquinelli P, et al. Cow’s milk protein allergy in children: A practical guide. Ital J Pediatr. 2010;36:5.CrossRefGoogle Scholar
- 27.Shi Y, Aledia AS, Tatavoosian AV, Vijayalakshmi S, Galant SP, George SC. Relating small airways to asthma control by using impulse oscillometry in children. J Allergy Clin Immunol. 2012;129:671–78.CrossRefGoogle Scholar
- 28.Dos Santos K, Fausto LL, Camargos PAM, Kviecinski MR, da Silva J. Impulse oscillometry in the assessment of asthmatic children and adolescents: From a narrative to a systematic review. Paediatr Respir Rev. 2017;23:61–7.PubMedGoogle Scholar
- 29.Sheldon J, Philips B. Laboratory investigation of anaphylaxis: Not as easy as it seems. Anaesthesia. 2015;70:1–5.CrossRefGoogle Scholar