Allergic Diseases: Diagnosis and Treatment by Randy J. Horwitz MD, PhD, Robert F. Lemanske Jr. MD (auth.),

By Randy J. Horwitz MD, PhD, Robert F. Lemanske Jr. MD (auth.), Phil Lieberman MD, John A. Anderson MD (eds.)

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Example text

The patient should understand that if the in vitro test is positive and consistent with the patient's history, the diagnosis is relatively assured, but a negative in vitro test does not exclude the possibility of sensitivity. In the face of a suggestive history and a negative in vitro test, the patient should still be skin tested before a final clinical judgment is made. In routine allergy practice, skin testing has been found to be more cost-effective than in vitro testing. The cost-effectiveness is more pronounced as multiple allergens are tested.

TOTAL SERUM IGE Test Methods Although a variety of assays have been used to measure the small concentrations of IgE normally present in human serum, the most frequently used method is a two site immunometric assay. The first antihuman IgE antibody is attached to a solid phase, such as a paper disk or plastic well in a microtiter plate. The solid phase is first incubated with an appropriate dilution of the serum to be tested. IgE in the serum becomes bound to the solid-phase anti-IgE in proportion to the concentration of IgE in the serum sample.

Ptero) Helminthosporium Cladosporium TREE POLLENS Maple Cottonwood Penicillium Phoma Stemphyllium Milk Peanut Chocolate Soybean Corn Chicken Pork Elm Beef Birch Shrimp Oak CONTROLS PR FOODS Oyster Pecan Histamine Cod fish Sycamore Control Tomato Willow Orange Ash Catfish Potato GRASS POLLENS Yeast Bahia Oat Bermuda Pecan Johnson Apple June/Kentucky String Bean Rye Onion Timothy Rice WEED POLLENS English Plantain Kochia Pigweed Giant Ragweed Short Ragweed Fig. 4. Allergy skin test record. also be used in patients with severe skin disease or dennatographism.

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