Allergen Profile, Pediatric, Birth to Three Years

CPT: 86003(x5)
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Test Details

Test Includes

Dermatophagoides farinae; egg white; milk (cow); soybean; wheat

Use

Measurement of specific IgE levels can be useful for the diagnosis of allergic disease and to define the allergens involved. This profile is designed for children who are younger than three years of age.

Methodology

Thermo Fisher ImmunoCAP®

Additional Information

It can be difficult to diagnose allergies in young children, since they are often unable to verbalize their symptoms.1 Moreover, the symptoms of allergic disease can overlap with those of bacterial and viral infections that are common in children. Testing for allergen-specific IgE levels can be useful in assessing the potential that an atopic disposition might play a role in fostering chronic sinusitis or dermatitis in these patients. Accurate diagnosis of the allergen sensitivity can allow the clinician to develop an optimal therapeutic approach. Early intervention can dramatically improve the child's symptoms and can reduce the chances of developing asthma in the future.2-5 The progressive development of increasingly debilitating allergic disease as an atopic child grows into adulthood has been referred to by some researchers as the “allergy march”.3,4,6 Children with a genetic predisposition towards the development of allergy (ie, atopic children) often start with sensitivity to foods that exhibits itself as atopic dermatitis during the first two years of life. After age two, these children often develop sensitivity to inhalant allergens, such as pollens or dust mites, producing allergenic rhinitis.3,6 Clinical studies have shown that children who develop atopic dermatitis2,4 or allergic rhinitis2,3,7 at a young age have an increased tendency to develop asthma as they grow older. Asthma is a chronic inflammatory disease that is characterized by airway obstruction and constriction of the bronchi of the lungs.2,7,8 Asthma can be a debilitating condition and results in more pediatric hospital admissions than any other cause.7 Over 75% of patients with asthma can be shown to have sensitivity to at least one common allergen7 or suffer from allergic rhinitis.6 Atopy is the strongest identifiable predisposing factor for the development of asthma.9 It has been hypothesized that allergic sensitization at a young age results in a state of chronic airway inflammation5,10 which, in turn, increases the child's susceptibility to nasal (sinusitis) and ear infections (otitis media). In fact, approximately 50% of children with chronic otitis media can be shown to have nasal allergy.10 Chronic allergy-mediated inflammation and associated infections are thought to cause mucosal damage and lung remodeling that can ultimately lead to asthma. A number of studies indicate that early treatment of allergy can change the course of disease progression.3-5 Clinical intervention seems to be most effective if the treatments are initiated before the age of six, increasing the importance of early diagnostic testing.9

Specimen Requirements

Specimen

Serum

Volume

0.5 mL

Container

Red-top tube or gel-barrier tube

Storage Instructions

Room temperature

Causes for Rejection

Improper labeling; gross hemolysis

Clinical Information

Footnotes

1. Fireman P. Therapeutic approaches to allergic rhinitis: Treating the child. J Allergy Clin Immunol. 2000; 105(6 Pt 2):S616-S621. 10856167
2. American Academy of Allergy, Asthma, and Immunology. The Allergy Report. Milwaukee, Wis: AAAAI; 2000.
3. Bousquet J, Van Cauwenberge P, Khaltaev N. World Health Organization. Allergic Rhinitis and Its Impact on Asthma. ARIA Workshop Report in Collaboration With the World Health Organization, 7-10 December 1999, Geneva, Switzerland. J Allergy Clin Immunol. 2001; 108(5 Suppl):S147-S334. 11707753
4. Allergic Factors Associated With the Development of Asthma and the Influence of Cetirizine in a Double-Blind, Randomised, Placebo-Controlled Trial: First Results of ETAC. Early Treatment of the Atopic Child. Pediatr Allergy Immunol. 1998; 9(3):116-124. 9814724
5. Martínez FD. Development of wheezing disorders and asthma in preschool children. Pediatrics. 2002; 109(2 Suppl):362-367.11826251
6. Titus K. Lab-based allergy testing on the march.CAP Today. March 2002.
7. Nimmagadda SR, Evans R. Allergy: Etiology and epidemiology. Pediatr Rev. 1999; 20(4):111-115.
8. Dolen WK. The diagnostic allergy laboratory. In: Rose NR, Hamilton RG, Detrick B, eds. Manual of Clinical Laboratory Immunology. 6th ed. Washington, DC: ASM Press; 2002: 883-890.
9. Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. Bethesda, Md: US Department of Health and Human Services, National Institutes of Health, 1997. NIH Publication 97-4051.
10. Skoner DP. Complications of allergic rhinitis. J Allergy Clin Immunol. 2000; 105(6 Pt 2):S605-S609.10856165

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
671935 Allergen Pediatric 0 - 3 Years 602444 Class Description N/A
671935 Allergen Pediatric 0 - 3 Years 602475 D002-IgE D farinae kU/L 6095-4
671935 Allergen Pediatric 0 - 3 Years 602452 F001-IgE Egg White kU/L 6106-9
671935 Allergen Pediatric 0 - 3 Years 602453 F002-IgE Milk kU/L 7258-7
671935 Allergen Pediatric 0 - 3 Years 602459 F004-IgE Wheat kU/L 6276-0
671935 Allergen Pediatric 0 - 3 Years 602457 F014-IgE Soybean kU/L 6248-9
Reflex Table for D002-IgE D farinae
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 602444 Class Description 602444 Class Description N/A
Reflex Table for F001-IgE Egg White
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 602444 Class Description 602444 Class Description N/A
Reflex Table for F002-IgE Milk
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 602444 Class Description 602444 Class Description N/A
Reflex Table for F004-IgE Wheat
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 602444 Class Description 602444 Class Description N/A
Reflex Table for F014-IgE Soybean
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 602444 Class Description 602444 Class Description N/A

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