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Memo to pediatricians: Allergy tests are no magic bullets for diagnosis
Date:12/25/2011

ast research has found that up to 8 percent of children have a positive skin or blood test for peanut allergies, but only 1 percent of them have clinical symptoms.

"Allergy tests can help a clinician in making a diagnosis but tests by themselves are not diagnostic magic bullets or foolproof predictors of clinical disease," Wood says. "Many children with positive tests results do not have allergic symptoms and some children with negative test results have allergies."

Undiagnosed allergies can be dangerous, even fatal, but over-reliance on blood and skin tests can lead to a misdiagnosis, ill-advised food restrictions or unnecessary avoidance of environmental exposures, such as pets.

In addition, the researchers caution, physicians should be careful when comparing results from different tests and laboratories because commercial tests vary in sensitivity. Also, laboratories may interpret tests results differently making an apples-to-apples comparison challenging, Wood says.

In their report, the scientists say, skin and blood tests can and should be used to:

  • Confirm a suspected allergic trigger after observing clinical reactions suggestive of an allergy. For example, children with moderate to severe asthma should be tested for allergies to common household or environmental triggers including pollen, molds, pet dander, cockroach, mice or dust mites.
  • Monitor the course of established food allergies via periodic testing. Levels of antibodies can help determine whether someone is still allergic, and progressively decreasing levels of antibodies can signify allergy resolution or outgrowing the allergy.
  • Confirm an allergy to insect venom following a sting that causes anaphylaxis, a life-threatening allergic reaction marked by difficulty breathing, lightheadedness, dizziness and hives.
  • Determine vaccine allergies (skin tests only).

Conversely, skin and blood tests should NOT be used:

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Contact: Ekaterina Pesheva
epeshev1@jhmi.edu
410-502-9433
Johns Hopkins Medical Institutions
Source:Eurekalert

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