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Allergens, Specific IgE Test

Test Number (See Individual Allergens in the Allergen Profiles section)
Test number copied
(See Individual Allergens in the Allergen Profiles section.)
(See Individual Allergens in the Allergen Profiles section)
CPT

86003 (each)

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.

Custom 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.

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

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