To help diagnose allergies; sometimes to monitor the effectiveness of immunotherapy (desensitization) treatment
Allergy Blood Testing
When you have symptoms such as hives, dermatitis, nasal congestion, red itchy eyes, asthma, or abdominal pain that your healthcare practitioner suspects may be caused by an allergy
A blood sample drawn from a vein in your arm
None
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How is it used?
The allergen-specific IgE antibody test is a blood test used to help diagnose an allergy to a specific substance or substances for a person who presents with acute or chronic allergy-like symptoms. This is especially true if symptoms are recurrent and appear to be tied to triggers, such as exposures to particular foods or environments, and if other family members are known to have allergies.
Other types of allergy tests may be performed by exposing a person to different substances under careful medical supervision. The usefulness of these tests, however, can be affected by skin conditions, such as significant dermatitis or eczema, and by medications, such as antihistamines and some antidepressants. With some tests there is also the potential for severe reactions, including, for example, anaphylaxis, which can be life-threatening. In these cases, the allergen-specific IgE antibody test may be ordered as an alternative, as it is performed on a blood sample.
The allergen-specific IgE antibody test may also be performed to monitor immunotherapy (desensitization) or to see if a child has outgrown an allergy. Typically, the healthcare practitioner will interpret the results of the test in comparison with a person's symptoms and any other allergy tests being performed.
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When is it ordered?
One or more allergen-specific IgE antibody tests may be ordered when a person has signs or symptoms that suggest an allergy to one or more substances. Signs and symptoms may include:
- Hives
- Dermatitis
- Eczema
- Red itchy eyes
- Coughing, nasal congestion, sneezing
- Asthma
- Itching and tingling in the mouth
- Throat tightness
- Trouble breathing
- Abdominal pain or vomiting and diarrhea
A test may also be ordered occasionally to help evaluate the effectiveness of immunotherapy or to determine whether a child has outgrown an allergy.
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What does the test result mean?
An elevated allergen-specific IgE result indicates that the person tested likely has an allergy. However, the amount of specific IgE present does not necessarily predict the potential severity of a reaction. A person's clinical history and additional medically-supervised allergy tests may be necessary to confirm an allergy diagnosis.
Negative results indicate that a person probably does not have a "true allergy," an IgE-mediated response to the specific allergens tested.
Results of allergy blood testing must be interpreted with care. False negatives and false positives can occur. Even if an IgE test is negative, there is still a small chance that a person does have an allergy. Similarly, if the specific IgE test is positive, a person may or may not ever have an actual physical allergic reaction when exposed to that substance.
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Is there anything else I should know?
Sometimes, a healthcare practitioner will look at other blood tests for an indirect indication of an ongoing allergic process, including a total IgE level or a complete blood count (CBC) and white blood cell differential (specifically eosinophils and basophils). Increases in these test results may suggest an allergy, but they may also be elevated for other reasons.
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What other tests are available for allergy testing?
Skin prick or scratch tests, intradermal tests, patch tests, and oral food challenges are usually performed by an allergist or dermatologist. These tests can be subjective and depend on factors such as dose of allergens, administration of the tests, and interpretation of results.
Your healthcare provider may also try eliminating foods from your diet and then reintroducing them to find out what you are allergic to. It is important that these tests be done under close medical supervision, as a life-threatening anaphylactic reaction is possible.
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My allergy test was negative, but I continue to have symptoms. What else could it be?
You could have an allergy-like condition that is not mediated by IgE for which there are no specific laboratory tests. You might have a genetic hypersensitivity problem, such as sensitivity to gluten with celiac disease or have an enzyme deficiency, such as a lactase deficiency causing lactose intolerance. It could also be another disease that is causing allergy-like symptoms. It is important to investigate your individual situation with your healthcare provider's assistance. Test results alone cannot diagnose allergies, but rather confirm a diagnosis when circumstances suggest an allergy is likely. Results from any type of allergy test have to be interpreted along with your medical history by a healthcare practitioner who is trained to diagnose allergies specifically.
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My allergy symptoms are generally mild. How serious is this really?
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Will my allergies ever go away?
Although children do outgrow some allergies, adults usually do not. Allergies that cause the worst reactions, such as anaphylaxis caused by peanuts, do not usually go away. Avoidance of the allergen and advance preparation for accidental exposure, in the form of medications such as antihistamines and portable epinephrine injections, is the safest course. Immunotherapy can help decrease symptoms for some unavoidable allergies but won't work for food and the treatment, which usually consists of years of regular injections, may need to be continued indefinitely.