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FOOD ALLERGY SCREENING TESTS (BY IMMUNO - EIA)

Allergy
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Report in 72Hrs

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nofastingrequire

No Fasting Required

Details

Antibody test for gluten sensitivity.

₹2,664₹3,806

30% OFF

Food Allergy Screening Tests (By Immuno-EIA) - Comprehensive Guide

  • Section 1: Why is it done?
    • Test Purpose: This test uses Enzyme-Linked Immunosorbent Assay (ELISA) technology to detect immunoglobulin E (IgE) antibodies against specific food allergens in the patient's blood serum.
    • Primary Indications: • Diagnosis of suspected IgE-mediated food allergies • Identification of specific food allergens causing symptoms • Evaluation of patients with gastrointestinal symptoms (vomiting, diarrhea, abdominal cramping) • Investigation of cutaneous reactions (urticaria, pruritus) • Respiratory symptoms associated with food consumption • Assessment of anaphylaxis risk from specific foods • Confirmation of clinical suspicion before allergen avoidance • Pre-treatment evaluation before immunotherapy consideration
    • Typical Timing and Circumstances: • Performed after detailed clinical history and symptom assessment • Can be done at any time (no acute phase requirement like some other immunological tests) • Ideal timing: 2-4 weeks after suspected allergic reaction has resolved • Used when skin prick testing is contraindicated or inconclusive • Appropriate for pediatric and adult populations • Can be performed regardless of current antihistamine or corticosteroid use • Useful during active allergy season for persistent investigations
  • Section 2: Normal Range
    • Reference Values and Units: • Measurement Unit: IU/mL (International Units per milliliter) or kU/L (kilounits per liter) • Normal/Negative Range: < 0.35 kU/L or < 0.10 IU/mL • Typically expressed as Class 0 or Class 1 (negative to minimal) • Results are typically reported individually for each specific food allergen tested
    • Result Classification System: • Class 0: < 0.35 kU/L (Negative - No detectable allergen-specific IgE) • Class 1: 0.35-0.69 kU/L (Borderline/Equivocal - Low level allergen-specific IgE) • Class 2: 0.70-3.5 kU/L (Positive - Low level allergen-specific IgE) • Class 3: 3.6-17.5 kU/L (Positive - Moderate level allergen-specific IgE) • Class 4: 17.6-50 kU/L (Very Positive - High level allergen-specific IgE) • Class 5: 50-100 kU/L (Very Positive - Very high level allergen-specific IgE) • Class 6: > 100 kU/L (Very Positive - Extremely high level allergen-specific IgE)
    • Interpretation of Results: • Negative (< 0.35 kU/L): IgE-mediated allergy to that specific food is unlikely; symptom relief with elimination diet not expected • Borderline (0.35-0.69 kU/L): Equivocal result requiring clinical correlation; repeat testing may be recommended • Positive (≥ 0.70 kU/L): IgE-mediated allergy to the specific food is probable; result correlates with clinical history • Higher classes (≥ 3.6 kU/L): Indicate greater likelihood of clinical reactivity and potentially more severe allergic reactions • Note: Positive results support clinical allergy but do not confirm it; clinical symptoms must correlate with results
  • Section 3: Interpretation
    • Detailed Result Interpretation: • Negative results: Exclude IgE-mediated allergy; patient can likely tolerate this food; however, non-IgE mediated allergies (like celiac disease) not detected • Low-positive results (Class 2): May represent true allergy or cross-reactivity; clinical correlation essential; consider graded oral food challenge if history is unclear • Moderate-to-high positive results (Class 3-4): Strong indication of IgE-mediated allergy; significant risk of clinical reaction; strict avoidance recommended • Very high positive results (Class 5-6): Extremely high likelihood of severe allergic reactions including anaphylaxis; absolute avoidance and epinephrine auto-injector prescription recommended
    • Clinical Significance of Result Patterns: • Single allergen positive: Specific food allergy confirmed; other tested foods likely safe • Multiple allergens positive: Suggests true allergic state; may indicate atopic individuals or cross-reactivity between botanically related foods • Isolated positive with negative history: Possible subclinical sensitization; not yet clinically manifesting; patient warrants education about potential future reactions • Completely negative panel: Reassuring for IgE-mediated allergies; if symptoms persist, investigate non-IgE mechanisms or non-allergic causes • Borderline results across multiple foods: Requires careful clinical correlation; repeat testing or alternative diagnostic methods may be warranted
    • Factors Affecting Test Results: • Recent allergen exposure: May temporarily elevate IgE levels • Timing after allergic reaction: IgE may take 2-4 weeks to peak • Seasonal variations: Some allergen-specific IgE levels fluctuate seasonally • Cross-reactivity: Botanically or immunologically related allergens may cause false positives • Laboratory variation: Results may differ slightly between laboratories; use same lab for serial monitoring • Patient age: Infants may have lower IgE levels; elderly patients may have age-related changes • Total IgE levels: Extremely high total IgE (> 2000 kU/L) may rarely affect test sensitivity • Recent immunotherapy: May suppress allergen-specific IgE levels • Technical factors: Sample handling, storage temperature, and time to processing affect accuracy
    • Clinical Significance and Predictive Value: • High specificity: Positive results accurately predict clinical allergy in 85-95% of cases when symptoms correlate • Sensitivity varies: 60-90% depending on allergen and patient population • Predictive value increases with higher class levels: Class 3+ results have > 95% positive predictive value • Natural history: IgE levels may decrease over years in some patients (spontaneous resolution) • Not diagnostic alone: Must combine with clinical history; serology alone cannot diagnose allergy • Useful for risk stratification: Helps determine severity of probable reaction and management intensity • Important for prognosis: Helps predict likelihood of resolution versus persistent allergy
  • Section 4: Associated Organs
    • Primary Organ Systems Involved: • Gastrointestinal Tract: Direct contact with allergen; most common site of reaction • Respiratory System: Sensitized airways react to inhaled food particles or vapors • Integumentary System (Skin): Manifestation of IgE-mediated response • Cardiovascular System: Involved in anaphylactic reactions • Central and Peripheral Nervous System: Mediator release affects neurological symptoms • Immune System: B-lymphocytes, T-lymphocytes, mast cells, and basophils drive the allergic response
    • Associated Medical Conditions: • Oral Allergy Syndrome (OAS): IgE-mediated reaction to raw fruits/vegetables; pollen cross-reactivity • Food-Dependent Exercise-Induced Anaphylaxis (FDEIA): Specific allergen causes reaction only with exercise • Eosinophilic Esophagitis: IgE and non-IgE mediated food allergies contribute to inflammation • Eosinophilic Gastroenteritis: Food allergen-induced eosinophilic infiltration of GI tract • Urticaria and Angioedema: Acute skin reactions from food allergen exposure • Asthma Exacerbation: Food allergen exposure can trigger or worsen asthma • Anaphylaxis: Life-threatening IgE-mediated reaction to food allergens • Allergic Rhinitis: May worsen with food allergen cross-reactivity • Atopic Dermatitis: Often associated with food sensitization; allergen exposure may exacerbate eczema • Mastocytosis: Increased mast cell burden increases anaphylaxis risk from food allergens
    • Potential Complications and Risks: • Anaphylaxis: Most serious complication; can occur within minutes of allergen exposure; requires immediate epinephrine • Acute Angioedema: Severe facial/airway swelling; potential airway obstruction • Severe Bronchospasm: Can be fatal without rapid intervention • GI Complications: Severe vomiting, diarrhea, abdominal pain; dehydration risk • Biphasic Reactions: Late-phase reaction occurring 4-12 hours after initial anaphylaxis • Psychosocial Impact: Anxiety, depression, social isolation from dietary restrictions • Nutritional Deficiencies: Overly restrictive elimination diets may cause malnutrition • Food Protein-Induced Enterocolitis Syndrome (FPIES): Non-IgE mediated but severe reaction • Secondary Infections: Severe skin reactions may become infected from scratching • Laryngeal Edema: Can be rapidly progressive and life-threatening
  • Section 5: Follow-up Tests
    • Complementary Diagnostic Tests: • Skin Prick Testing (SPT): Confirms IgE-mediated allergy; faster and cheaper than serology; requires careful patient selection • Component-Resolved Diagnostics (CRD): Identifies specific allergenic epitopes; useful for cross-reactivity assessment • Oral Food Challenge (OFC): Gold standard for allergy confirmation; should be performed under medical supervision • Total IgE Level: Determines baseline immune status; extremely high levels may affect interpretation • Tryptase Level: Elevated in anaphylaxis; helps confirm mast cell degranulation • Complete Blood Count (CBC): May show eosinophilia suggesting allergic response • Histamine Level: Elevated during acute reactions; reflects mast cell activation
    • Recommended Follow-up Based on Results: • Negative Results: Patient reassurance; no further testing needed unless symptoms persist and suggest alternative diagnosis • Borderline Results (Class 1): Recommend clinical trial of allergen avoidance; repeat testing in 4-8 weeks; consider SPT for confirmation • Low-Positive Results (Class 2): Consider OFC if clinical history is atypical; may not require strict avoidance if no previous reaction • Moderate-Positive Results (Class 3): Recommend allergen avoidance; prescribe epinephrine auto-injector; consider allergist referral • High-Positive Results (Class 4-6): Urgent allergist referral; strict allergen avoidance; mandatory epinephrine auto-injector; consider allergen immunotherapy • Multiple Positive Results: Comprehensive nutritional assessment; referral to allergist and dietitian; may need expanded testing panel
    • Monitoring and Serial Testing: • Annual Monitoring: Recommended for children with food allergies to assess for natural resolution • Repeat Testing Intervals: Every 1-2 years for stable patients; sooner if clinical symptoms change • Triggers for Repeat Testing: Changes in tolerance (new reactions or improvements), age milestones (school entry, adolescence), or clinical uncertainty • Trend Monitoring: Decreasing IgE levels may indicate spontaneous resolution (especially in children) • Post-Immunotherapy Monitoring: Serial testing if undergoing oral immunotherapy (OIT) or sublingual immunotherapy (SLIT) • Prognosis Assessment: Declining IgE suggests better prognosis for resolution; persistent high levels indicate chronic allergy
    • Related Investigations and Specialist Referrals: • Allergist/Immunologist Consultation: Essential for confirmed allergies or complex presentations • Gastroenterology Referral: If symptoms suggest GI involvement (eosinophilic esophagitis, gastroenteritis) • Pulmonology Evaluation: For patients with respiratory manifestations or asthma • Dermatology Consultation: For severe or persistent cutaneous manifestations • Dietitian Referral: Critical for education on allergen avoidance and nutritional adequacy • Anxiety/Mental Health Evaluation: For patients with significant psychosocial impact from food allergy • Pediatric Subspecialty: For children with complex or severe food allergies • Pharmacist Consultation: For medication interactions and optimal epinephrine auto-injector use
  • Section 6: Fasting Required?
    • Fasting Requirement: NO - Fasting is NOT required for food allergy screening tests by Immuno-EIA.
    • Rationale: • IgE antibodies are stable in blood and not significantly affected by fasting status • Food intake does not interfere with allergen-specific IgE measurement • Test measures circulating antibodies, not digestive function or recent food consumption • Unlike glucose or lipid tests, no metabolic state alterations needed for accurate results • Patient comfort and convenience enhanced by absence of fasting requirement
    • Medication Considerations: • Antihistamines (H1 and H2 blockers): NO need to discontinue; do not affect serum IgE levels • Corticosteroids (oral, topical, intranasal): NO need to stop; do not interfere with test • Leukotriene Inhibitors: No interference with test results • Beta-blockers and ACE Inhibitors: No impact on test; continue normal medications • Tricyclic Antidepressants: No effect on IgE measurement; continue as prescribed • Omalizumab (Anti-IgE Therapy): May artificially lower IgE levels; inform laboratory if patient taking this medication • Immunosuppressants: May reduce IgE levels; inform physician and laboratory • Continue ALL regular medications unless specifically instructed otherwise by physician
    • Optimal Timing Considerations: • Avoid testing immediately after acute allergic reaction (within 2-4 weeks ideally) • Best performed after symptoms resolve to get accurate baseline IgE levels • Avoid concurrent acute infections; fever may transiently affect immune markers • Consider timing for patients with seasonal symptoms; test during high-symptom periods if seasonal allergy suspected • For children, any time of day acceptable; morning or afternoon makes no difference • Can test at any time during the day; circadian variations minimal for allergen-specific IgE
    • Patient Preparation Requirements: • Maintain Normal Diet: Eat and drink normally; can consume favorite foods day of test • No Special Precautions: Patient can eat breakfast before morning draw • Hydration: Patient should be well-hydrated; improves venipuncture success • Avoid Excessive Activity: Not necessary to restrict exercise or activity • Emotional State: Minimize stress if possible; stress doesn't affect results but causes discomfort • Clothing: Wear loose-fitting sleeves for easy arm access during blood draw • Identification: Bring photo ID and insurance information • Medical History: Inform phlebotomist of current medications and medical conditions • Allergen Avoidance: No need to avoid suspected allergens before test • Recent Illness: Minor cold/illness doesn't require postponement; significant fever may warrant delay • Skin Integrity: If dermatitis or wounds present on both arms, inform technician • Laboratory Instructions: Follow any facility-specific requirements communicated at appointment scheduling
    • Important Pre-Test Information: • Document Clinical History: Provide detailed symptom timeline and suspected allergen triggers • Specific Foods Requested: Ensure lab knows which specific allergens to test (peanuts, tree nuts, milk, eggs, shellfish, fish, wheat, sesame, soy, etc.) • Previous Test Results: Bring prior test results if available for comparison • Vaccination Timing: Live vaccines should be given after blood draw to avoid contamination • Recent Transfusions: Inform if received blood products recently (rare impact but important for records) • Multiple Test Requests: Specify all suspected allergens upfront to minimize needle sticks • Appointment Duration: Allow 15-30 minutes for complete process including check-in and blood draw • Results Timeline: Typically available within 24-72 hours; confirm expected reporting timeframe • Physician Communication: Ensure ordering physician will receive and review results • Patient Consent: Confirm understanding of test purpose, procedure, and limitations before proceeding

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