What are the main types of allergy tests. How accurate are skin prick tests compared to blood tests. When should you consult an allergist for allergy testing. What factors can affect allergy test results. How do allergists interpret allergy test results.

Understanding Allergy Testing: Types and Procedures

Allergy testing is a crucial step in identifying and managing allergic conditions. Both adults and children can undergo allergy tests, which can be performed as early as the first consultation with an allergist. These tests help pinpoint specific allergens triggering symptoms, enabling allergists to develop tailored treatment plans.

There are two primary types of allergy tests:

• Skin tests
• Blood tests

While both methods can detect sensitivities to common allergens like pollen, dust mites, foods, and medications, skin testing is generally preferred by trained allergists due to its accuracy and quick results.

Skin Testing: The Gold Standard

Skin testing is considered the gold standard in allergy diagnostics. It offers several advantages:

• Rapid results
• Cost-effectiveness compared to blood tests
• High accuracy when performed by trained professionals

There are two main types of skin tests:

1. Prick or scratch test: A tiny amount of allergen is pricked or scratched into the skin’s surface.
2. Intradermal test: A small amount of allergen is injected under the skin using a thin needle.

Skin tests can detect allergies to various substances, including plant pollens, molds, animal dander, insect venom, foods, and certain medications like penicillin.

Blood Testing: An Alternative Approach

Blood tests for allergies involve a single needle prick and can be useful in specific situations. Some advantages of blood testing include:

• No interference from medications
• Lower risk of allergic reactions during testing
• Suitable for patients with severe skin conditions

However, blood tests have some drawbacks:

• Longer turnaround time for results
• Higher cost compared to skin tests
• Potential for false positives in some cases

The Role of Allergists in Accurate Diagnosis

Board-certified allergists play a crucial role in the accurate diagnosis and management of allergies. These specialists are trained to:

• Select appropriate tests based on individual patient factors
• Interpret test results in the context of medical history
• Develop personalized treatment plans
• Stay updated on the latest research and testing methods

Why is it important to consult an allergist for allergy testing? Allergists have specialized training in selecting and interpreting allergy tests, ensuring accurate diagnosis and effective treatment. They consider various factors when choosing tests, including:

• Patient symptoms
• Environmental and occupational exposures
• Age
• Hobbies and lifestyle factors

Factors Affecting Allergy Test Results

Several variables can influence the accuracy of allergy test results:

• Medications: Some medications can interfere with skin test results
• Testing method: The skill of the tester can affect accuracy
• Type of allergen: Some allergens are more challenging to detect than others
• Patient’s overall health: Certain medical conditions may impact test results
• Cross-reactivity: Some allergens may cause false positives due to similarities in structure

How do allergists account for these factors? Allergists take a comprehensive approach by:

• Reviewing the patient’s complete medical history
• Performing a physical examination
• Considering potential cross-reactivity between allergens
• Using their expertise to interpret results in the context of the patient’s overall health

The Importance of Proper Test Selection

Choosing the right allergy test is crucial for accurate diagnosis. Allergists carefully select tests based on:

• The patient’s specific symptoms
• Suspected allergens
• The patient’s age and overall health
• The likelihood of false positives or negatives

Why is random allergy testing discouraged? Random testing can lead to unnecessary procedures, false positives, and misdiagnosis. Allergists use their expertise to select tests that are most likely to identify the specific allergens causing symptoms, improving diagnostic accuracy and treatment outcomes.

Interpreting Allergy Test Results

Interpreting allergy test results requires specialized knowledge and experience. Allergists consider various factors when analyzing test outcomes:

• The size of the skin reaction in skin tests
• The level of specific antibodies in blood tests
• The patient’s clinical history and symptoms
• Potential cross-reactivity between allergens
• The likelihood of false positives or negatives

How do allergists differentiate between sensitization and clinical allergy? Allergists understand that a positive test result doesn’t always indicate a clinically relevant allergy. They use their expertise to determine whether a patient is merely sensitized to an allergen or has a true allergy causing symptoms. This distinction is crucial for developing appropriate treatment plans and avoiding unnecessary dietary restrictions or lifestyle changes.

Managing Allergy Symptoms and Treatment Options

Once allergies are accurately diagnosed, allergists can recommend appropriate treatment options. These may include:

• Avoidance strategies for identified allergens
• Medications to manage symptoms (e.g., antihistamines, nasal corticosteroids)
• Immunotherapy (allergy shots or sublingual tablets)
• Lifestyle modifications to reduce exposure to allergens
• Emergency action plans for severe allergic reactions

How do allergists develop personalized treatment plans? Allergists consider various factors when creating treatment plans:

• The specific allergens identified through testing
• The severity and frequency of symptoms
• The patient’s age and overall health
• Potential side effects of treatments
• The patient’s preferences and lifestyle

The Future of Allergy Diagnostics

Advancements in allergy testing and diagnostics continue to improve patient care. Some emerging areas of research include:

• Component-resolved diagnostics (CRD) for more precise allergen identification
• Basophil activation tests for drug and food allergies
• Molecular-based allergy diagnostics
• Artificial intelligence-assisted interpretation of test results
• Non-invasive biomarker testing for allergic diseases

How might these advancements impact allergy care in the future? These new technologies and approaches have the potential to:

• Increase diagnostic accuracy
• Reduce the need for provocative challenge tests
• Enable more personalized treatment strategies
• Improve the understanding of cross-reactivity between allergens
• Facilitate earlier diagnosis and intervention in allergic diseases

Finding an Allergist: Steps to Take Control of Your Allergies

If you suspect you have allergies, consulting with a board-certified allergist is crucial for accurate diagnosis and effective treatment. Here are steps to find an allergist:

1. Check with your primary care physician for recommendations
2. Use the American College of Allergy, Asthma & Immunology’s allergist locator tool
3. Verify the allergist’s credentials and board certification
4. Read patient reviews and testimonials
5. Consider the allergist’s areas of specialization and experience

What should you expect during your first visit to an allergist? During your initial consultation, the allergist will typically:

• Review your medical history and symptoms
• Perform a physical examination
• Recommend appropriate allergy tests
• Discuss potential treatment options
• Address any questions or concerns you may have

By working with a qualified allergist, you can take control of your allergies and improve your quality of life. Accurate diagnosis through appropriate testing is the first step towards effective management of allergic conditions.

Testing and Diagnosis – Find An Allergist Today

Allergy Testing

Adults and children of any age can be tested for allergies. As soon as your first consultation, you can get tested. Once the results are in and the diagnosis is done, your allergist can sit down with you and tell you what you’re allergic to and, even better, what you can do about it. 

Your allergist may want to do skin testing, blood testing, or both. Any kind of allergy test is best done under the guidance of an allergist. These specialists are trained in the best methods for diagnosing and treating allergies.

Both blood and skin allergy tests can detect a patient’s sensitivity to common inhalants like pollen and dust mites or to medicines, certain foods, latex, venom, or other substances. Skin testing is the preferred method used by trained allergists, and is usually the most accurate. Blood tests may be ordered in specific situations.

It’s important to choose the right test, the one best able to aid the diagnostic process. For many reasons, that’s not an easy job. Allergy patients are often sensitized to many allergens, but are only clinically allergic to one or more specific substances. Allergists are trained to select tests that pinpoint the allergens which are actually causing the symptoms. 

These skills are important because there are many variables that can affect allergy test results. Correctly identifying a person’s specific allergic triggers helps an allergist develop the best therapies and management plans for each patient.

Board-certified allergists are specialists trained to help you take control of your allergies and asthma, so you can live the life you want. These specialists recognize that not all allergy tests are alike. They regularly review the scientific literature to learn which testing systems work better than others and how laboratory practices may affect test results.

Allergy tests should not be ordered randomly, either. They are chosen based on symptoms, environmental and occupational exposures, age, and even hobbies. All results are then interpreted in the context of the patient’s medical history.

Tests can be done for common allergens such as plant pollens, molds, dust mites, animal dander, insect stings and various foods such as peanuts, eggs, wheat, shellfish and milk. Testing also is available for some medicines, such as penicillin.

Types of Allergy Tests

Skin Testing

Allergy skin testing is the gold standard and is used along with the medical history to find out exactly what things a person is allergic to. 

Some medicines can interfere with skin testing, so you should let your allergist know about any medications you’re taking.

Skin tests are done in an allergist’s office. Skin tests give fast result and usually cost less than allergy blood tests. 

However, while testing may seem simple, it must be carried out by trained practitioners with an understanding of the variables and risks of the testing procedure. The skill of the tester can also affect the accuracy of the results.

Steps should include:

• After reviewing the patient’s medical history and performing a physical exam, the allergist determines that allergy skin testing is both appropriate and safe to perform on you that day.
• A trained staff member performs the skin testing under the supervision of the allergist.
• The skin test is read and graded for the level of response.

There are two types of skin tests:

• Prick or scratch test: In this test, a tiny drop of a possible allergen—something you are allergic to— is pricked or scratched into the skin. (This is also called a percutaneous test.) It is the most common type of skin test.
• Intradermal test: This test shows whether someone is allergic to things such as insect stings and penicillin. A small amount of the possible allergen is injected under the skin through a thin needle.

Skin tests for allergic disorders have been used successfully for more than 100 years. Today, prick or scratch tests are the most commonly-used type of skin test. These tests are not very invasive and, for most allergens, they tend to produce quick results. If the results of prick or scratch tests are negative, they may be followed by intradermal tests, which give allergists more details about what’s causing the symptoms.

Allergy symptoms might occur during the test. The most common symptoms are itching and swelling of the skin. In rare cases, a more serious reaction can occur, so skin testing should always be done by a specialist.

Blood Testing

Blood testing involves a single needle prick, and medicine does not interfere with the results. However, it takes a long time to get the results, and depending on the test, there can be false positives. Blood tests cost more than skin tests. There are many types of allergy blood tests, and some are more helpful than others.

The risk with allergy blood tests is pain or bleeding at the needle mark. Also, a few people may faint during blood testing.

Allergy Diagnosis

Blood test and skin test results alone do not diagnose allergies. All test results, from either type of test, must be interpreted together with your medical history.

When it comes to human allergic disease, an individual’s medical history is as important as the results of an allergy test. Medical history is the critical link between allergy test results and allergic disease itself. It tells the allergist valuable information about your health overall, your experiences with possible allergens, your symptoms at various times of the year, etc. 

If the results of skin and blood allergy tests are not clear or are inconsistent with the patient’s medical history, allergists rely on their training and experience along with a patient’s medical history and a physical examination—not test results—to make the final diagnosis.

Diagnosing Food Allergies | Symptoms &Treatment

Your First Appointment

Your first step toward relief is to schedule an appointment with an allergist to receive a proper diagnosis. Your allergist will evaluate several things before making an allergy diagnosis, and it’s nice to know what to expect.

Your allergist will begin by taking a detailed medical history. They will ask detailed questions about your history of allergy symptoms, your diet, your family’s medical history, and your home and living area. Some questions your allergist may ask include:

• The symptoms you have after eating the food.
• How long after eating the food these symptoms occurred.
• How much of the food you had.
• How often the reaction has occurred.
• Whether it occurs with other foods.
• Whether it occurs every time you eat the food.
• What type of medical treatment, if any, you received after having symptoms.

These questions help your allergist find out what is causing your allergy or making your symptoms worse. For example, allergy to pollen in the air, such as ragweed pollen, can be the cause of the swelling or itching in your mouth and throat if you eat certain foods like melons.

Your allergist may recommend allergy tests, such as a skin test or blood test to determine if you have a food allergy. A sensitivity to a food can be indicated in a skin prick test or a blood test, but does not always show a true allergy unless there has been a previous reaction to the food. These tests may offer clues about the causes of symptoms, but they cannot determine whether someone has a food allergy with absolute certainty. If necessary, an oral food challenge may be used to positively confirm the food that is causing the problem.

When a food allergy is suspected, it’s critically important to consult an allergist, who can decide which food allergy tests to perform, determine if food allergy exists, and counsel you on food allergy management once the diagnosis has been made.

Elimination Diet

Your allergist may narrow the search for foods causing allergies by placing you on a special diet. You may be asked to keep a daily food diary. The diary lists all food you eat and medication you take, along with your symptoms for the day.

If only one or two foods seem to cause allergies, you may try avoiding them. In this diet, you do not eat the suspect food at all for one to two weeks. If the allergic symptoms decrease during that period and flare up when you eat the food again, it is very likely the food causing your allergy.

However, which food you should avoid (and for how long) and when you should eat the food again (if ever) should be decided together with your allergist. You should never try to eat even a small quantity of any food your allergist has determined may cause a risk of anaphylaxis.

Your allergist may want to confirm these diet tests with a challenge test. Food allergy testing is a very important step in diagnosing food allergies.

Food Allergy Testing

 If done correctly and interpreted by a board-certified allergist, skin tests or blood tests are reliable and can rule food allergy in or out.

Your allergist will interpret the test results and use them to aid in a diagnosis. While both kinds of testing can signal a food allergy, neither is conclusive. A positive test result to a specific food does not always indicate that a patient will react to that food when it’s eaten. A negative test is more helpful to rule out a food allergy. Neither test can predict how severely a patient will react if they eat a specific food. Some people test “allergic” to a food (by skin or blood testing) and yet have no symptoms when they eat that food.

Skin Testing

Skin prick tests are conducted in a doctor’s office and provide results within 15-30 minutes. A nurse or the allergist administers these tests on the patient’s arm or back by pricking the skin with a small, sterile probe that contains a tiny amount of the food allergen. The tests, which are not painful but can be uncomfortable (mostly itchy), are considered positive if a wheal (resembling a mosquito bite bump) develops at the site.

The size of a wheal does not necessarily predict how severe your reaction might be if you eat that food.

Blood Testing

Blood tests, which are less sensitive than skin prick tests, measure the amount of IgE Bacteria, viruses and other microorganisms commonly contain many antigens, as do pollens, dust mites, molds, foods, and other substances. Although many types of antibodies are protective, inappropriate or excessive formation of antibodies may lead to illness. When the body forms a type of antibody called IgE (immunoglobulin E), allergic rhinitis, asthma or eczema may result when the patient is again exposed to the substance which caused IgE antibody formation (allergen).</span>” rel=”tooltip”>antibody to the specific food(s) being tested. Results are typically available in about one to two weeks and are reported as a number.

The level of IgE antibodies found for a specific food does not necessarily predict how severe your reaction will be if you eat that food.

Oral Food Challenge

To confirm your test results, your allergist may recommend an oral food challenge, which is the gold standard for food allergy diagnosis. However, the procedure can be costly, time-consuming, and in some cases is potentially dangerous, so it is not routinely performed.

During an oral food challenge, the patient is fed gradually increasing amounts of the suspected allergy-causing food over a period of time under strict supervision by an allergist. Emergency medication and emergency equipment must be on hand during this procedure.

Oral food challenges may also be performed to determine if a patient has outgrown a food allergy.

Food Allergy Diagnosis

Diagnosing food allergies can be complicated. Symptoms of food allergy can vary from person to person, and a single individual may not always experience the same symptoms during every reaction. Food allergic reactions can affect the skin, respiratory tract, gastrointestinal tract, and/or cardiovascular system, and people may develop food allergies at different ages.

Your allergist will look at both your test results and your medical history to make a food allergy diagnosis. 

If you are diagnosed with food allergies, your allergist will prescribe an epinephrine auto-injector and teach you how to use it.

You’ll need to be careful to avoid eating foods you are allergic to. Ask your allergist what safety precautions you need to take.

Basic principles for the diagnosis of allergic diseases – MEDSI

Allergy is a disease that manifests itself in the form of an acute sensitivity of the human body to various allergen substances upon contact with them.

To develop an effective treatment program, it is necessary to identify the causes of the disease, as well as the list of substances that cause the reaction. As in the case of other ailments, in order to achieve the maximum result of therapy, the diagnosis and treatment of allergic diseases must be carried out at an early stage.

Most significant allergy symptoms

Seek medical attention if the following symptoms appear:

• Skin rashes and itching
• Difficulty breathing (including deterioration of respiratory function before sleep)
• Chronic coryza, persistent sneezing, itchy nose
• Edema of different localization
• Redness and itching of the eyes, profuse lachrymation
• Bronchial asthma

These signs manifest themselves differently in each specific case, since an allergic reaction can occur to different groups of allergen substances:

• Food (fruits, dairy products, etc. ) (food form of allergy)
• Dust, pollen, wool (respiratory form)
• Some constituents of cosmetics and perfumes, plants, etc. on tactile contact (dermal form)

Also, the reaction may occur due to prolonged exposure to the sun and other reasons.

Main types of allergotests

Various types of allergotests are used to diagnose allergic diseases:

• Group of in vivo tests – carried out with the direct participation of the patient:
• Conjunctival examination (preparation is placed between the eyeball and eyelid)
• Skin tests (a scratch or small puncture is made on the skin through which the allergen is injected)
• Sublingual test (drug is inserted under the tongue)
• Nasal mucosal samples (allergen is injected into the mucosa)
• Group of in vitro tests – laboratory tests:
• Blood test for specific immunoglobulins E – ELISA (enzymatic immunoassay)

When analyzing reactions of the skin, mucous membranes, etc. , the appearance of an allergic reaction and its further course are monitored. In this case, the patient may experience discomfort.

In addition to allergy tests, the following types of examinations are used to diagnose the disease:

• Physical examination of the patient, interview and history taking
• Instrumental inspection
• Spirometer analysis with bronchodilation test to detect bronchospasm
• Measurement of various physical parameters (temperature, pressure, etc.)

Food Allergy Diagnosis

Food allergy testing uses a questionnaire, anamnesis, and various tests and trials.

To determine this type of allergy, the following manipulations are performed:

• The patient keeps a food diary in which he records the nature of the food, the time of intake, as well as the manifestation of any reactions of the body
• For two weeks he follows a doctor-specified diet that eliminates potential allergens
• After a period of corrective nutrition, the patient, under the supervision of doctors on an empty stomach, takes a capsule containing a potential allergen to which it is necessary to determine the reaction
• If there is no such reaction, the dose of the given allergen may be increased
• If the response to the maximum dose is not monitored, the test product is no longer considered an allergen
• In parallel, radioallergy and enzyme immunoassays are performed
• The diagnosis is confirmed if the patient’s condition returns to normal after a hypoallergenic diet

Diagnosis of drug allergy

When a reaction to drugs is detected, the doctor receives information not only from the patient himself, but also from his relatives, who may notice a deterioration in the patient’s condition after taking the medication.

At the same time, an ELISA blood test is performed to determine the concentration of antibodies indicating the presence or absence of an allergy.

It is important to remember that an allergic reaction to a particular drug may differ even in the same person: one day it may manifest itself in the form of urticaria and itching, and another time in the form of Quincke’s edema. Also, an allergy to medications can be hereditary and manifest itself in a number of family members.

Diagnosis of allergic diseases in children

Children’s immunity is not fully formed, so some methods of diagnosing allergies are not applied to children. So, skin tests are used only in cases where it is necessary to confirm a reaction to vaccines, food, or seasonal allergies.

The main methods for diagnosing allergies in a child are a survey and history taking, as well as laboratory blood tests for antibody concentrations. But it should be remembered that the signs of allergy as a result of such studies will only appear if the child has already encountered one of the allergens, even if he has a genetic predisposition to this type of allergy.

Reading and interpretation of tests and tests

Allergy test results should normally be:

A qualified allergist will interpret the results of all tests and prescribe the best treatment.

Advantages of the procedure at MEDSI

• Allergic diseases are diagnosed at MEDSI by immunologists-allergists of high qualification categories
• The network of clinics has its own research laboratories that allow manipulations in CITO mode
• 4 types of specially designed allergen panels are used for examining children
• MEDSI doctors use a comprehensive approach to treat allergies, which includes: reduction or complete cessation of contact with the allergen, drug therapy that suppresses symptoms, allergen-specific immunotherapy (ASIT)

To make an appointment with an allergist-immunologist, call 8 (495) 7-800-500.

Do not delay treatment, see a doctor now:

• Allergist-immunologist appointment
• Consultation of a pediatric allergist
• Treatment of food allergies in children

Diagnosis and treatment of various allergic diseases – Allergist-immunologist – Department of general practice with personal supervision – Departments

Diagnosis and treatment of various allergic diseases

DIAGNOSIS . There are many ways to diagnose allergies. The correct diagnosis can be made only after a comprehensive examination and never after a single analysis. A comprehensive allergological examination begins with a conversation with an allergist. The doctor asks about complaints, about the onset of the disease, the features of its development, about the conditions in which the allergic reaction is most pronounced, about the presence of similar diseases in relatives, living and working conditions. After that, the doctor prescribes certain diagnostic methods.

Skin test: A prick test (prick test) or scratch test (scratch test) is done to determine which allergens may be relevant in the development of symptoms in an individual. These are absolutely painless methods. The study, as a rule, is carried out on the skin of the forearm, which is pre-treated with an alcohol solution. Next, drops of allergens are applied to clean skin. In the case of scarification tests, small scratches are applied through drops of allergens with a disposable scarifier. After some time, slight swelling and redness of the skin may develop, suggesting an allergy to the substance in question.

Test for specific antibodies Ig E: This test for antibodies responsible for the development of allergies helps to identify a group of causative allergens. The method is very sensitive, and the information obtained is essentially similar to that obtained as a result of skin testing. To conduct this analysis, you will need to donate blood from a vein.

Provocative tests: Skin testing and IgE blood tests indicate those allergens that can potentially cause allergic reactions in this person. If after skin tests and blood tests, the diagnosis remains unclear, the doctor may prescribe provocative tests. Such studies are carried out in allergological hospitals according to strict indications. When conducting provocative tests, a small amount of the allergen is injected into the nose, under the tongue or directly into the bronchi, and after a while the reaction is evaluated. Such a study can cause a severe allergic reaction in the patient, so it should be carried out in the presence of a doctor who can provide immediate medical attention.

Elimination tests: If exposure to an allergen is persistent, then elimination tests are used to confirm that that particular allergen is causing the clinical manifestations of the allergy. Elimination is the removal of an allergen. A typical example of an elimination test is the elimination diet. This is a diagnostic technique, which consists in the complete removal of the alleged allergenic product from the diet. If after the exclusion of the product within 7-14 days there is a visible improvement in the course of the disease, then we can say that this product is the cause of the allergy.

To diagnose allergies and correct treatment, the doctor may ask you to keep a special diary in which the patient will note the time of onset of the allergy, the manifestations and the possible cause. This allows you to prescribe a preventive treatment or exclude contact with the allergen, for example, in the case of pollen allergy or food allergy.

Allergy laboratory testing is just one part of a comprehensive allergological examination. Based on them, the doctor can suggest the cause of the allergy. An accurate diagnosis can be made only with the combination of all the data: a survey, examination, laboratory data and response to treatment.

TREATMENT. In addition to selecting the optimal symptomatic pharmacological therapy for allergic diseases, an allergist-immunologist conducts ASIT, which is also called specific immunotherapy, specific desensitization, specific desensitization, allergen immunotherapy, allergovaccinotherapy or allergy vaccination.

An allergist-immunologist prescribes ASIT if there is a history of confirmed IgE-dependent allergic diseases. Treatment is carried out using standardized drugs, the effectiveness and safety of which is confirmed in practice. ASIT is prescribed in the following cases:

• If it is impossible to stop the patient’s contact with the allergen, for example, in the case of household dust.
• If the clinical manifestations of the disease have clear evidence of the influence of a particular allergen.
• If allergen tests (prick tests and in vitro antibody tests) confirm an IgE-dependent mechanism of sensitization.
• If there are no more than three allergens.