Guidelines for improved patient care

Guidelines and position papers around the world recommend usage of Specific IgE blood testing in the allergy diagnosis

Several authorities have developed guidelines on diagnosing and management of allergy. One of the main objectives with these guidelines have been to help clinicians to identify individuals with allergy and their offending allergens at an early stage. Consequently, clinicians can manage the patients appropriately and increase patient well-being.

This page gathers important statements from guidelines around the world in regards to:

  • When, why and who to perform allergy testing
  • Role of specific IgE blood testing, both extracts and components, in diagnosing, evaluation of  risk and follow up patients with allergy
  • Health economy data in relation to allergy blood testing

The guidelines are presented in chronological order:

BSACI* - Immunotherapy for allergic rhinitis. UK 2011.

“…immunotherapy is more likely to be effective in patients sensitized to disease-relevant allergens, and component resolved diagnosis may facilitate identification of better responders and perhaps even ‘tailor making’ of vaccines for individuals.”

“Many ‘allergens’ are mixtures of various proteins to which individuals are variably sensitized. The formation of IgE antibodies to some of these proteins appears to be associated with a greater risk of developing clinical symptoms of rhinoconjunctivitis than others.”

“This may partly underlie the poor ability of SPT to predict clinical responsiveness to the majority of allergen ‘mixes’.”

*British Society for Allergy and Clinical Immunology. Ref: Walker. S.M et al. Immunotherapy for allergic rhinitis. Clinical & Experimental Allergy, 41, 1177–1200.

 

NICE* - Diagnosis and assessment of food allergy in children and young people in primary care and community settings. UK 2011.  

“Based on the results of the allergy-focused clinical history, if IgE-mediated allergy is suspected, offer the child or young person a skin prick test and/or blood tests for specific IgE antibodies to the suspected foods and likely co-allergens”

”Skin prick tests should only be undertaken where there are facilities to deal with an anaphylactic reaction.”

”…health economic evidence showed that both the IgE antibody test and the skin prick test were cost effective compared with no test…” 

”…inclusion of future retesting improves the cost effectiveness…” 

To learn more about these guidelines and how they can be translated into clinical practice, please read our brochure "Is it food allergy? Be sure. Be safe"

*National Institute for Health and Clinical Excellence in United Kingdom. Ref: NICE http://guidance.nice.org.uk/CG116/Guidance.

 

NIH* - Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of NIAID-Sponsored Expert Panel. US 2010.

The NIH guideline is the first consensus document aimed at a broader group of healthcare professionals on how to diagnose and manage food allergy.

”The Expert Panel recommends sIgE tests for identifying foods that potentially provoke IgE-mediated food-induced allergic reactions...”

“The predictive values associated with clinical evidence of allergy for ImmunoCAP® cannot be applied to Turbo-MP and Immulite.”

“Results of follow-up testing can guide decision-making regarding whether and when it is safe to introduce or re-introduce allergenic food into the diet”

To learn more about these guidelines and how they can be translated into clinical practice, please read our brochure "Is it food allergy? Be sure. Be safe"

*National Institutes of Health. Ref: Boyce J et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of NIAID-Sponsored Expert Panel. J Allergy Clin Immunol 2010; 126: S1–S58.

 

NIH* - Guidelines for the Diagnosis and Management of Asthma. US 2007. 

“For successful long-term management of asthma, it is essential to identify and reduce exposures to relevant allergens…”

“Allergy testing is the only reliable way to determine sensitivity to perennial indoor allergens…”

“Use skin testing or in vitro testing to determine the presence of specific IgE antibodies to the indoor allergens to which the patient is exposed year round.”

 *National Institutes of Health. Ref: NIH publication 08-4051.

 

EAACI* - Allergy testing in children: why, who, when and how? Europe 2003. European Academy of Allergy and Clinical Immunology

“Generally, all children with persisting/recurrent/severe “allergic symptoms” or individuals with need for continuous treatment should be tested for allergy irrespective of the age of the child.”

“In selected patients with food allergy attending a highly specialized pediatric allergy department, more than 95% of food allergies were correctly identified (Pharmacia CAP System). Thus, specific IgE tests may eliminate the need for double-blind placebo-controlled food challenges in selected referred children with severe food allergy.”

“Test for specific IgE should be conducted with a validated method (91–94) and can be performed at any age.”

*European Academy of Allergy and Clinical Immunology. Ref: Høst. A et al. Allergy testing in children: why, who, when and how? Allergy 2003: 58: 559–569. 

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.