Establishing a diagnosis of an allergy to seasonal inhalants
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response and/or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
RYEG | Rye Grass, IgE | Yes | Yes |
JUNE | June Grass, IgE | Yes | Yes |
SRW | Short Ragweed, IgE | Yes | Yes |
EGPL | English Plantain, IgE | Yes | Yes |
LAMQ | Lambs Quarter, IgE | Yes | Yes |
BXMPL | Box Eld/Maple, S, IgE | Yes | Yes |
OAK | Oak, IgE | Yes | Yes |
ELM | Elm, IgE | Yes | Yes |
TIMG | Timothy Grass, IgE | Yes | Yes |
BIR | Silver Birch, IgE | Yes | Yes |
Fluorescence Enzyme Immunoassay (FEIA)
Box Elder/Maple
Elm
English Plantain
June Grass
Lambs Quarter
Oak
Rye Grass
Short Ragweed
Silver Birch
Timothy Grass
Serum
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.
0.75 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 90 days |
Establishing a diagnosis of an allergy to seasonal inhalants
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response and/or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with allergen.
In vitro serum testing for IgE antibodies provides an indication of the immune response to allergens that may be associated with allergic disease.
The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. In individuals predisposed to develop allergic disease, the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children younger than 5 years of age due to food sensitivity (milk, egg, soy, and wheat proteins), followed by respiratory disease (rhinitis and asthma) in older children and adults due to sensitivity to inhalant allergens (dust mites, mold, and pollen inhalants).
Class | IgE kU/L | Interpretation |
0 | <0.10 | Negative |
0/1 | 0.10-0.34 | Borderline/equivocal |
1 | 0.35-0.69 | Equivocal |
2 | 0.70-3.49 | Positive |
3 | 3.50-17.4 | Positive |
4 | 17.5-49.9 | Strongly positive |
5 | 50.0-99.9 | Strongly positive |
6 | > or =100 | Strongly positive |
Reference values apply to all ages.
Detection of IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.
The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.
Testing for IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.
Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and test results must be interpreted in the clinical context.
False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.
Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070
Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)
Monday through Friday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
86003 x 10
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SEAS | Seasonal Inhalants Allergen Profile | 94593-1 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
BIR | Silver Birch, IgE | 15283-5 |
BXMPL | Box Eld/Maple, S, IgE | 7155-5 |
EGPL | English Plantain, IgE | 6110-1 |
ELM | Elm, IgE | 6109-3 |
JUNE | June Grass, IgE | 6153-1 |
LAMQ | Lambs Quarter, IgE | 6156-4 |
OAK | Oak, IgE | 6189-5 |
RYEG | Rye Grass, IgE | 7369-2 |
SRW | Short Ragweed, IgE | 6085-5 |
TIMG | Timothy Grass, IgE | 6265-3 |