How are allergies diagnosed and treated?

Allergies are characterized by an immune-mediated inflammatory response to typically harmless environmental allergens, and their diagnosis and treatment are critical for managing symptoms and improving quality of life.

Key Insights:

Allergy diagnosis relies on a combination of patient history and the detection of allergen-specific IgE, typically through skin prick testing or blood specific testing .
Skin prick testing, while effective, carries risks and should be performed with medical supervision for safety and accurate interpretation.
Allergen immunotherapy is an established treatment for various allergic conditions, including stinging insect allergy, allergic rhinitis, and asthma, and is more commonly provided by allergy specialists .
Nonprescription medications are widely used by patients for allergy symptoms, and general practitioners often diagnose allergies without using allergy testing.
Food allergy diagnosis may require controlled food elimination and challenge procedures in addition to skin prick tests and allergen-specific serum IgE tests .
Recombinant allergens have enabled component-resolved diagnosis (CRD), improving the selection of candidates for specific immunotherapy and monitoring its immunological efficacy.

Conclusion:

The diagnosis of allergies is primarily based on patient history and the identification of specific IgE antibodies, with skin prick and blood tests being the most common diagnostic methods. Allergen immunotherapy is a key treatment, especially when administered by allergy specialists. General practitioners often rely on symptom management without specific allergy testing. For food allergies, additional diagnostic steps such as elimination diets and food challenges are necessary. The use of recombinant allergens in testing has enhanced the precision of allergy diagnosis and the personalization of treatment strategies.

How are allergies diagnosed and treated?

Summary

Sources and full results

1. Diagnosis, treatment and prevention of allergic disease: the basics

Allergy diagnosis relies on symptom history and allergen-specific IgE testing, and effective treatments include allergen immunotherapy and allergen avoidance.

Diagnosis and treatment of nasal and ocular allergies: the Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) surveys.

Most patients with allergic rhinoconjunctivitis (ARC) are treated with nonprescription medications or general practitioners, who often don't use allergy testing, while allergist/immunologists and otolaryngologists perform allergy tests and provide allergen immunotherapy.

Practical aspects of allergy-testing.

Allergy-testing is essential for determining specific allergen avoidance measures, pharmacotherapy, and vaccination, and is recommended for children with persisting, recurrent or severe allergic symptoms.

Diagnosis and Management of Food Allergy.

Food allergy diagnosis and management involve allergen avoidance and appropriate treatment, with potential treatments including immunotherapy, biologics, and novel vaccines.

Testing children for allergies: why, how, who and when

Adolescents with persisting, recurrent, or severe symptoms suggestive of allergies should undergo allergy testing for optimal care and treatment.

A prospective assessment of the remote practice of allergy: comparison of the diagnosis of allergic disease and the recommendations for allergen immunotherapy by board-certified allergists and a laboratory performing in vitro assays.

Remote practice of allergy, using in vitro assays and patient information forms, accurately diagnoses allergic diseases and recommends treatment without direct patient contact.

Allergy testing in children: why, who, when and how?

This paper establishes evidence-based recommendations on allergy testing in children, emphasizing the importance of cooperation between primary care physicians and specialists in allergy to ensure high-quality diagnosis and treatment.

Diagnosing and managing allergic conjunctivitis in childhood: The allergist’s perspective

Allergists can effectively diagnose and manage allergic conjunctivitis in children using non-pharmacological treatments, eye drops, and cyclosporine.

Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report.

Food allergy is a public health issue with no current treatment, but can be managed through allergen avoidance or treatment of symptoms, and these guidelines provide 43 concise clinical recommendations for healthcare professionals.

Allergy testing: the role of recombinant allergens

Recombinant allergens improve diagnosis and monitoring of type I allergy, enabling better selection for specific immunotherapy and vaccines.

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