Specimen Requirements


Specimen

Serum


Volume

0.1 mL per allergen


Minimum Volume

0.07 mL per allergen


Container

Red-top tube or gel-barrier tube


Storage Instructions

Room temperature


Causes for Rejection

Improper labeling; gross hemolysis


Test Details


Use

Detect possible allergic responses to various substances in the environment and evaluate for hay fever, asthma, atopic eczema, and respiratory allergy. The quantitative allergen-specific IgE test is indicated (1) to determine whether an individual has elevated allergen-specific IgE antibodies; (2) if specific allergic sensitivity is needed to allow immunotherapy to be initiated; (3) when testing individuals for agents that may potentially cause anaphylaxis; (4) when evaluating individuals who are taking medication (eg, long-acting antihistamines) that may interfere with other testing modalities (eg, skin testing); (5) if immunotherapy or other therapeutic measures based on skin testing results have not led to a satisfactory remission of symptoms; (6) when an individual is unresponsive to medical management where identification of offending allergens may be beneficial.


Limitations

Quantitative allergen-specific IgE test results should be interpreted in the context of all available clinical and laboratory findings. High levels of total IgE (>3000 IU/mL as may be seen due to parasitic infestation or other conditions) may result in nonspecific binding. Testing in these patients should be re-evaluated once the medical condition has been eliminated.


Methodology

Thermo Fisher ImmunoCAP®


Additional Information

Identification of allergen or allergens in patients with atopic disease may be approached clinically by history, physical findings, skin and/or quantitative allergen-specific IgE testing. Numerous reports comparing skin testing and quantitative allergen-specific IgE have accumulated in the literature, generally to assess which method has the better sensitivity/specificity.


References

American Academy of Allergy, Asthma, and Immunology. The Allergy Report. Milwaukee, Wis: AAAAI; 2000.
Bousquet J, Van Cauwenberge P, Khaltaev N, et al. 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 Nov: 108(5 Suppl):S147-334. 11707753
Dolen WK. Skin testing and immunoassays for allergen-specific IgE. Clin Rev Allergy Immunol. 2001 Oct; 21(2-3):229-239. 11725606
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.
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.
Nalebuff DJ. RAST allergen screening: A cost-effective approach to allergy diagnosis. In: Fadal RF, Nalebuff, DJ, eds. RAST in Clinical Allergy. Symposia Foundation; 1989:35-49.
Nalebuff DJ. Use of RAST screening in clinical allergy: A cost-effective approach to patient care. Ear Nose Throat J. 1985 Mar; 64(3):107-121. 3920041
Nalebuff DJ, Fadal RG, Ali M. Determination of initial immunotherapy dose for ragweed hypersensitivity with the modified RAST test. Otolaryngol Head Neck Surg. 1981 Mar-Apr; 89(2):271-274. 6787525
Nimmagadda SR, Evans R. Allergy: Etiology and epidemiology. Pediatr Rev. 1999 Apr; 20(4):111-115; quiz 116.
Yunginger JW, Ahlstedt S, Eggleston PA, et al. Quantitative IgE antibody assays in allergic diseases. J Allergy Clin Immunol. 2000 Jun; 105(6 Pt 1):1077-1084.10856139

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