World Allergy Organization Journal (Feb 2020)
IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper
- Ignacio J. Ansotegui, MD, PhD,
- Giovanni Melioli, MD,
- Giorgio Walter Canonica, MD,
- Luis Caraballo, MD, PhD,
- Elisa Villa, MD, PhD,
- Motohiro Ebisawa, MD, PhD,
- Giovanni Passalacqua, MD,
- Eleonora Savi, MD,
- Didier Ebo, MD, PhD,
- R. Maximiliano Gómez, MD, PhD,
- Olga Luengo Sánchez, MD, PhD,
- John J. Oppenheimer, MD,
- Erika Jensen-Jarolim, MD,
- David A. Fischer, MD,
- Tari Haahtela, MD,
- Martti Antila, MD,
- Jean J. Bousquet, MD, PhD,
- Victoria Cardona, MD, PhD,
- Wen Chin Chiang, MBBS,
- Pascal M. Demoly, MD, PhD,
- Lawrence M. DuBuske, MD,
- Marta Ferrer Puga, MD,
- Roy Gerth van Wijk, MD, PhD,
- Sandra Nora González Díaz, MD, PhD,
- Alexei Gonzalez-Estrada, MD,
- Edgardo Jares, MD,
- Ayse Füsun Kalpaklioğlu, MD,
- Luciana Kase Tanno, MD, PhD,
- Marek L. Kowalski, MD, PhD,
- Dennis K. Ledford, MD,
- Olga Patricia Monge Ortega, MD,
- Mário Morais Almeida, MD,
- Oliver Pfaar, MD, PhD,
- Lars K. Poulsen, PhD,
- Ruby Pawankar, MD, PhD,
- Harald E. Renz, MD, PhD,
- Antonino G. Romano, MD, PhD,
- Nelson A. Rosário Filho, MD, PhD,
- Lanny Rosenwasser, MD,
- Mario A. Sánchez Borges, MD,
- Enrico Scala, MD,
- Gian-Enrico Senna, MD,
- Juan Carlos Sisul, MD,
- Mimi L.K. Tang, MBBS, PHD,
- Bernard Yu-Hor Thong, MD,
- Rudolf Valenta, MD,
- Robert A. Wood, MD,
- Torsten Zuberbier, MD, PhD
Affiliations
- Ignacio J. Ansotegui, MD, PhD
- Hospital Quironsalud Bizkaia, Bilbao-Erandio, Spain; Corresponding author.
- Giovanni Melioli, MD
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Giorgio Walter Canonica, MD
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Rozzano, Milan, Italy
- Luis Caraballo, MD, PhD
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia
- Elisa Villa, MD, PhD
- Azienda Sanitaria Locale di Vercelli, S.C. Pneumologia, Vercelli, Italia
- Motohiro Ebisawa, MD, PhD
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
- Giovanni Passalacqua, MD
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
- Eleonora Savi, MD
- Ospedale Civile, Gossolengo, PC, Italy
- Didier Ebo, MD, PhD
- Department of Immunology - Allergology - Rheumatology, Antwerp University Hospital, Antwerp University, Department Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
- R. Maximiliano Gómez, MD, PhD
- Universidad Católica de Salta, Fundación Ayre, Buenos Aires, Argentina
- Olga Luengo Sánchez, MD, PhD
- Allergy Section, Department of Internal Medicine, Vall d’Hebron University Hospital, Barcelona, Spain
- John J. Oppenheimer, MD
- Pulmonary & Allergy Associates, Denville, NJ, USA
- Erika Jensen-Jarolim, MD
- Institute for Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, Vienna, Austria
- David A. Fischer, MD
- Fischer Medicine Professional Corporation, Barrie, Ontario, Canada
- Tari Haahtela, MD
- Skin and Allergy Hospital, University of Helsinki, Helsinki, Finland
- Martti Antila, MD
- Clínica de Alergía, Sorocaba, São Paulo, Brazil
- Jean J. Bousquet, MD, PhD
- MACVIA-France, Montpellier, France; INSERM, Villejuif, France; Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France; Euforea, Brussels, Belgium; CHU Montpellier, France
- Victoria Cardona, MD, PhD
- Universitat Autónoma de Barcelona, Hospital Universitario Vall d'Hebron, Servicio de Medicina Interna, Sección de Alergología, Barcelona, Spain
- Wen Chin Chiang, MBBS
- Mount Elizabeth Medical Centre, Chiang Children's Allergy & Asthma Clinic, Singapore, Singapore
- Pascal M. Demoly, MD, PhD
- University Hospital Montpellier, Montpellier, France; Sorbonne Université, Paris, France
- Lawrence M. DuBuske, MD
- Immunology Research Institute of New England, Gardner, MA, USA
- Marta Ferrer Puga, MD
- The Unidad de Educación Médica, Department of Medical Education, School of Medicine, Clinica Universitad de Navarra, Navarra, Spain
- Roy Gerth van Wijk, MD, PhD
- Erasmus MC, Sector Allergologie, Rotterdam, the Netherlands
- Sandra Nora González Díaz, MD, PhD
- Universidad Autónoma de Nuevo León, Hospital Universitario, Monterrey, Nuevo León, Mexico
- Alexei Gonzalez-Estrada, MD
- Department of Allergy, Mayo Clinic, Jacksonville, FL, USA
- Edgardo Jares, MD
- Femeca Femedica, Buenos Aires, Argentina
- Ayse Füsun Kalpaklioğlu, MD
- Kirikkale Universitesi, Tip Fakultesi, Kirikkale, Turkey
- Luciana Kase Tanno, MD, PhD
- Hospital Sírio Libanês, University of São Paulo, São Paulo, Brazil
- Marek L. Kowalski, MD, PhD
- Faculty of Medicine, Department of Clinical Immunology & Allergy, Medical University of Łódź, Łódź, Poland
- Dennis K. Ledford, MD
- University of South Florida College of Medicine, Tampa, FL, USA
- Olga Patricia Monge Ortega, MD
- Allergology Unit, San Juan de Dios Hospital, University of Costa Rica, San José, Costa Rica
- Mário Morais Almeida, MD
- Hospital CUF-Descobertas, Lisbon, Portugal
- Oliver Pfaar, MD, PhD
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
- Lars K. Poulsen, PhD
- Gentofte University Hospital, Lab for Allergology, Allergy Clinic, Hellerup, Denmark
- Ruby Pawankar, MD, PhD
- Nippon Medical School, Dept. of Otolaryngology, Tokyo, Japan
- Harald E. Renz, MD, PhD
- University Hospital GI & MR GmbH, Institute of Laboratory Medicine & Pathology, Standort Marburg, Marburg, Germany
- Antonino G. Romano, MD, PhD
- IRCCS Oasi Maria S.S., Troina, Italy; Fondazione Mediterranea G.B. Morgagni, Catania, Italy
- Nelson A. Rosário Filho, MD, PhD
- University of Parana, Curitiba, PR, Brazil
- Lanny Rosenwasser, MD
- University of Missouri at Kansas City, School of Medicine, Kansas City, MO, USA
- Mario A. Sánchez Borges, MD
- Centro Médico Docente La Trinidad, Caracas, Venezuela
- Enrico Scala, MD
- Experimental Allergy Unit, Istituto Dermopatico dell'Immacolata, Rome, Italy
- Gian-Enrico Senna, MD
- Ospedale Civile Maggiore, Verona, Italy
- Juan Carlos Sisul, MD
- Allergy & Asthma Institute, Asunción, Paraguay
- Mimi L.K. Tang, MBBS, PHD
- Royal Children's Hospital, Department of Allergy & Immunology, Parkville, Victoria, Australia
- Bernard Yu-Hor Thong, MD
- Tan Tock Seng Hospital, Deptartment of Rheumatology, Allergy & Immunology, Singapore, Singapore
- Rudolf Valenta, MD
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
- Robert A. Wood, MD
- Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
- Torsten Zuberbier, MD, PhD
- Campus Charite Mitte, Klinik fur Dermatologie & Allergologie, Berlin, Germany
- Journal volume & issue
-
Vol. 13,
no. 2
Abstract
Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen. Keywords: IgE, Allergy, In vitro tests, Skin tests, Diagnostic strategies
