PMID- 24039169
OWN - NLM
STAT- MEDLINE
DCOM- 20140514
LR  - 20160511
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Linking)
VI  - 3
IP  - 10
DP  - 2013 Oct
TI  - Total serum immunoglobulin E as a marker for missed antigens on in vitro allergy 
      screening.
PG  - 782-7
LID - 10.1002/alr.21207 [doi]
AB  - BACKGROUND: The diagnosis of inhalant allergies involves a medical history, 
      physical exam, and allergen sensitivity testing; allergen sensitivity can be 
      assessed by a specific immunoglobulin E (IgE) screen for inhalant allergens. Some 
      patients with clinical suspicion for inhalant allergies have a negative specific 
      IgE screen, but high total IgE. We theorize that elevated total IgE may indicate 
      a false-negative screen caused by "missed allergens" not initially identified. 
      METHODS: Study patients with a negative allergy screen and elevated IgE (>116 
      kU/L) were identified (n = 26). Control patients (n = 26) were defined as having 
      a negative screen and an IgE <2.95 kU/L. Both groups were tested with an expanded 
      specific IgE panel and completed a questionnaire about other causes of elevated 
      IgE. RESULTS: The expanded panel was positive for inhalant allergens in 4 study 
      patients (15%) and 0 control patients (p = 0.037). Within the study patients, 50% 
      had asthma and 76.9% had chronic sinusitis. Only 2 control patients had asthma 
      (11.5%), p = 0.003; 4 (19.2%) reported chronic sinusitis, p < 0.0001. Food 
      allergen sensitivity was identified in 5 study patients and 1 control, p = 0.083. 
      CONCLUSION: This pilot study evaluated patients clinically suspected of allergy 
      with a negative inhalant IgE screen. Those with a high total IgE were more likely 
      to have a missed inhalant allergen on expanded testing, as well as asthma and 
      chronic sinusitis, compared to those with a low total IgE. Further investigation 
      of "missed antigen" and the role of chronic respiratory inflammatory disease in 
      patients with elevated total IgE is warranted.
CI  - (c) 2013 ARS-AAOA, LLC.
FAU - Hatcher, Jeanne L
AU  - Hatcher JL
AD  - Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, NC.
FAU - Cohen, Samuel D
AU  - Cohen SD
FAU - Mims, J Whit
AU  - Mims JW
LA  - eng
PT  - Journal Article
DEP - 20130822
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
RN  - 0 (Allergens)
RN  - 0 (Biomarkers)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Allergens/*immunology
MH  - Biomarkers/blood
MH  - Case-Control Studies
MH  - Child
MH  - Chronic Disease
MH  - Delayed Diagnosis
MH  - Humans
MH  - Immunoglobulin E/*blood
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Radioallergosorbent Test
MH  - Retrospective Studies
MH  - Rhinitis, Allergic
MH  - Rhinitis, Allergic, Perennial/*diagnosis
MH  - Surveys and Questionnaires
MH  - Young Adult
OTO - NOTNLM
OT  - allergic rhinitis
OT  - asthma
OT  - immunoglobulin E
OT  - radioallergosorbent test
OT  - respiratory hypersensitivity
OT  - sinusitis
EDAT- 2013/09/17 06:00
MHDA- 2014/05/16 06:00
CRDT- 2013/09/17 06:00
PHST- 2012/09/27 00:00 [received]
PHST- 2013/05/21 00:00 [revised]
PHST- 2013/06/18 00:00 [accepted]
PHST- 2013/09/17 06:00 [entrez]
PHST- 2013/09/17 06:00 [pubmed]
PHST- 2014/05/16 06:00 [medline]
AID - 10.1002/alr.21207 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2013 Oct;3(10):782-7. doi: 10.1002/alr.21207. Epub 2013 
      Aug 22.