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Indian Pediatrics

, Volume 56, Issue 11, pp 951–957 | Cite as

Allergy Testing — An Overview

  • Neeraj GuptaEmail author
  • Poojan Agarwal
  • Anil Sachdev
  • Dhiren Gupta
Rational Diagnostics

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 test 

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Notes

Funding: None; Competing interest: None stated.

References

  1. 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. 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. 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. 4.
    Chandrika D. Allergic rhinitis in India: an overview. Int J Otorhinolaryngol Head Neck Surg. 2017;3:1–6.CrossRefGoogle Scholar
  5. 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. 6.
    Igea JM. The history of the idea of allergy. Allergy. 2013;68:966–73.CrossRefGoogle Scholar
  7. 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. 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. 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. 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. 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. 12.
    Treudler R, Simon JC. Overview of component resolved diagnostics. Curr Allergy Asthma Rep. 2013;13:110–7.CrossRefGoogle Scholar
  13. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 29.
    Sheldon J, Philips B. Laboratory investigation of anaphylaxis: Not as easy as it seems. Anaesthesia. 2015;70:1–5.CrossRefGoogle Scholar

Copyright information

© Indian Academy of Pediatrics 2019

Authors and Affiliations

  • Neeraj Gupta
    • 1
    Email author
  • Poojan Agarwal
    • 2
  • Anil Sachdev
    • 1
  • Dhiren Gupta
    • 1
  1. 1.Division of Pediatric Emergency, Critical Care, Pulmonology and Allergic Disorders, Department of Pediatrics, Institute of Child HealthSir Ganga Ram HospitalRajinder Nagar, DelhiIndia
  2. 2.Department of PathologySir Ganga Ram HospitalRajinder Nagar, DelhiIndia

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