PMID- 2643916
OWN - NLM
STAT- MEDLINE
DCOM- 19890227
LR  - 20190619
IS  - 0003-4819 (Print)
IS  - 0003-4819 (Linking)
VI  - 110
IP  - 4
DP  - 1989 Feb 15
TI  - Diagnostic tests for patients with suspected allergic disease. Utility and 
      limitations.
PG  - 304-12
AB  - STUDY OBJECTIVE: To evaluate the clinical efficacy of diagnostic tests used for 
      persons with suspected allergic disease. DESIGN: Information synthesis based on 
      historical review of developments in the understanding of the pathophysiology of 
      allergic diseases and on selected recent literature on efficacy of specific 
      diagnostic tests. MAIN RESULTS: Skin testing is most effective when based on 
      clues from the patient's history. The sensitivity and specificity of skin testing 
      methods are compared: skin prick testing alone is often sufficient to identify or 
      exclude immunoglobulin E (IgE)-mediated hypersensitivity, including food allergy. 
      Except for penicillin and certain macromolecules, skin testing is not useful for 
      evaluating drug allergy. Skin test titration may be useful for determining the 
      starting dose for immunotherapy; otherwise it is rarely necessary. The patch skin 
      test helps identify the cause of allergic contact dermatitis. Bronchial 
      provocation testing is useful in special cases. Oral provocation testing may be 
      used to identify allergy or other intolerance to suspected foods, food additives, 
      and certain drugs. Provocation testing is time-consuming and requires special 
      precautions. In-vitro methods for identifying allergen-specific IgE are 
      especially useful when skin testing is unreliable, equivocal, or cannot be done. 
      In-vitro tests should be used as adjuncts to the clinical interview and 
      examination. CONCLUSIONS: Tests that are effective for identifying allergenic 
      substances usually can be determined from a careful patient interview. Clinicians 
      should be aware of nonspecific test results and allergy tests of unproven 
      effectiveness.
FAU - VanArsdel, P P Jr
AU  - VanArsdel PP Jr
AD  - University of Washington School of Medicine, Seattle.
FAU - Larson, E B
AU  - Larson EB
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Ann Intern Med
JT  - Annals of internal medicine
JID - 0372351
RN  - 0 (Immunoglobulin G)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 9007-36-7 (Complement System Proteins)
SB  - IM
CIN - Ann Intern Med. 1990 Aug 15;113(4):331-2. PMID: 2134986
MH  - Adult
MH  - Bronchial Provocation Tests/methods
MH  - Child
MH  - Complement System Proteins/analysis
MH  - Drug Hypersensitivity/diagnosis
MH  - Evaluation Studies as Topic
MH  - Food Hypersensitivity/diagnosis
MH  - Humans
MH  - Hypersensitivity/*diagnosis
MH  - Hypersensitivity, Delayed/etiology
MH  - Hypersensitivity, Immediate
MH  - Immunoglobulin E/analysis/immunology
MH  - Immunoglobulin G/analysis
MH  - In Vitro Techniques
MH  - Lymphocytes/classification/immunology
MH  - Radioallergosorbent Test/methods
MH  - Skin Tests/methods
RF  - 45
EDAT- 1989/02/15 00:00
MHDA- 2001/03/28 10:01
CRDT- 1989/02/15 00:00
PHST- 1989/02/15 00:00 [pubmed]
PHST- 2001/03/28 10:01 [medline]
PHST- 1989/02/15 00:00 [entrez]
AID - 10.7326/0003-4819-110-4-304 [doi]
PST - ppublish
SO  - Ann Intern Med. 1989 Feb 15;110(4):304-12. doi: 10.7326/0003-4819-110-4-304.