Allergy tests are a series of tests used to determine the
substances to which a person is allergic.
Other Names:
Patch tests - Scratch test - Skin tests - RAST test
How it is done:
There are many types of allergy testing.The three most common tests are the
skin tests, elimination-type tests, and the radioallergosorbent test (RAST).
Skin tests are the most common. The scratch test, one of the most
common modes, involves placement of a small amount of suspected allergen
substance on the skin (usually the forearm, upper arm, or the back), and
then scratching or pricking the skin so that the allergen is introduced
under the skin surface. The skin is observed closely for signs of a
reaction, usually swelling and redness of the site,a controlled hive with
so-called wheal and flare. Results are usually obtained within about 20
minutes. Several suspected allergens can be tested at the same time.
A similar mode involves injection of a small amount of allergen under the
surface of the skin (intradermal) and watching for a reaction. Skin tests
are most useful for respiratory allergies, a penicillin allergy , insect
bite allergies, and food testing.
Food allergies are usually tested by using various elimination diets
-- the suspected foods are eliminated from the diet for several weeks and
then gradually re-introduced one at a time while the person is observed for
signs of an allergic reaction . Because a person might believe he or she is
allergic to a certain food, a double-blind test may be advised to find out
if this is true. In a double-blind test, suspected foods and placebos
(harmless substances) are given in a disguised form. The person being tested
and the provider are both unaware of whether the substance tested in that
session is the placebo or the food substance. A third party knows the
identity of the substances and identifies them with some sort of code. This
test requires several sessions if more than one substance is under
investigation.
While this strategy is useful and practical for mild allergic reactions, it
must be undertaken carefully in individuals with suspected severe reactions
to foods. In this instance, blood tests may be a safer first approach, as
described below. Of note, skin testing is almost never performed to detect
food allergies for the same reason of the higher risk of causing a severe
allergic reaction.
The RAST is a laboratory test performed on blood . It tests for the
amount of specific IgE antibodies in the blood, which are present if there
is a true allergic reaction.
Other tests include immunoglobulin measurements, and the blood cell
differential or absolute eosinophil count (increased eosinophils can
indicate the presence of allergy). Provocation (challenge) testing
includes exposure to the suspected allergen -- for example, in the diet
or by inhaling the suspected allergen -- under controlled circumstances.
This type of test may provoke severe allergic reactions. Challenge testing
should only be done by a physician.
Preparation for the test:
Before any allergy testing, the health care provider will ask for a very
detailed medical history. This may include questions about such things as
illnesses, emotional and social conditions, work, entertainment, lifestyle,
foods, and eating habits.
If skin testing will be performed, it is necessary that you not take
antihistamines prior to the test. This may lead to a false-negative result,
falsely reassuring you that a substance is unlikely to cause a severe
allergic reaction. Your doctor will tell you which medicines to avoid and
when to stop taking them before the test.
How the test will feel:
Skin test may cause very mild discomfort when the skin is scratched or
pricked. Itching may accompany a positive reaction to the allergen.
Why the test is performed:
Allergy tests are used to determine the specific substances that cause an
allergic reaction in an individual. They may also be used to determine if a
group of symptoms is a true allergic reaction, which involves antibodies and
histamine release. Some food intolerances, in which there is an inability to
digest a food because of lack of appropriate enzymes, mimic allergies. Some
drugs, such as aspirin, can cause allergy-like symptoms without the
formation of antibodies or the release of histamine.
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