Allergic conjunctivitis laboratory findings: Difference between revisions
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[[In-vitro]] tests to detect [[IgE]] [[antibodies]] to specific [[allergens]] are widely used<ref name="pmid29996875">{{cite journal| author=Arasi S, Corsello G, Villani A, Pajno GB| title=The future outlook on allergen immunotherapy in children: 2018 and beyond. | journal=Ital J Pediatr | year= 2018 | volume= 44 | issue= 1 | pages= 80 | pmid=29996875 | doi=10.1186/s13052-018-0519-4 | pmc=6042356 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29996875 }} </ref> if skin testing is indicated but not advised such as<ref name="pmid31993069">{{cite journal| author=Dupuis P, Prokopich CL, Hynes A, Kim H| title=A contemporary look at allergic conjunctivitis. | journal=Allergy Asthma Clin Immunol | year= 2020 | volume= 16 | issue= | pages= 5 | pmid=31993069 | doi=10.1186/s13223-020-0403-9 | pmc=6975089 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31993069 }} </ref>: | [[In-vitro]] tests to detect [[IgE]] [[antibodies]] to specific [[allergens]] are widely used<ref name="pmid29996875">{{cite journal| author=Arasi S, Corsello G, Villani A, Pajno GB| title=The future outlook on allergen immunotherapy in children: 2018 and beyond. | journal=Ital J Pediatr | year= 2018 | volume= 44 | issue= 1 | pages= 80 | pmid=29996875 | doi=10.1186/s13052-018-0519-4 | pmc=6042356 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29996875 }} </ref> if skin testing is indicated but not advised such as<ref name="pmid31993069">{{cite journal| author=Dupuis P, Prokopich CL, Hynes A, Kim H| title=A contemporary look at allergic conjunctivitis. | journal=Allergy Asthma Clin Immunol | year= 2020 | volume= 16 | issue= | pages= 5 | pmid=31993069 | doi=10.1186/s13223-020-0403-9 | pmc=6975089 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31993069 }} </ref>: | ||
*The patient cannot discontinue [[antihistaminic]] [[medications]] | *The patient cannot discontinue [[antihistaminic]] [[medications]] | ||
===[[Conjunctival]] [[allergen]] challenge=== | |||
The conjunctival allergen challenge involves instillation of an allergen on the ocular surface with subsequent evaluation of the local response. A control solution is instilled in the other eye [39]. This is predominantly done in research settings to test novel treatments or to compare existing therapies. In the clinical setting, the conjunctival allergen challenge is underused yet is particularly helpful to identify local allergies in patients who have symptoms suggestive of AC but who have negative or discordant skin prick testing and serum specific IgE [29]. The challenge is also useful to assess the relationship between symptoms and exposure in polysensitized patients and to assess response to therapy after it has been initiated [29, 39]. | |||
*Ambiguous results (e.g., presence of [[dermatographism]]) | *Ambiguous results (e.g., presence of [[dermatographism]]) | ||
*To complement the results of previous skin testing. | *To complement the results of previous skin testing. | ||
Revision as of 04:03, 30 August 2022
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Overview
Allergic conjunctivitis is usually a clinical diagnosis. Laboratory tests are primarily supportive. They may help in differentiating intrinsic and extrinsic forms of the condition and thus, guide the treatment.
Laboratory findings
Skin prick test
- Intradermal injections of individual allergens are administered to detect sensitivity[1].
- It is a highly sensitive test[2].
- The result is considered positive when the resulting wheal is at least 3 mm larger than the negative control. Systemic reactions are rare[3].
IgE estimation
In-vitro tests to detect IgE antibodies to specific allergens are widely used[4] if skin testing is indicated but not advised such as[5]:
- The patient cannot discontinue antihistaminic medications
Conjunctival allergen challenge
The conjunctival allergen challenge involves instillation of an allergen on the ocular surface with subsequent evaluation of the local response. A control solution is instilled in the other eye [39]. This is predominantly done in research settings to test novel treatments or to compare existing therapies. In the clinical setting, the conjunctival allergen challenge is underused yet is particularly helpful to identify local allergies in patients who have symptoms suggestive of AC but who have negative or discordant skin prick testing and serum specific IgE [29]. The challenge is also useful to assess the relationship between symptoms and exposure in polysensitized patients and to assess response to therapy after it has been initiated [29, 39].
- Ambiguous results (e.g., presence of dermatographism)
- To complement the results of previous skin testing.
References
- ↑ La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S; et al. (2013). "Allergic conjunctivitis: a comprehensive review of the literature". Ital J Pediatr. 39: 18. doi:10.1186/1824-7288-39-18. PMC 3640929. PMID 23497516.
- ↑ Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R; et al. (2008). "Allergy diagnostic testing: an updated practice parameter". Ann Allergy Asthma Immunol. 100 (3 Suppl 3): S1–148. doi:10.1016/s1081-1206(10)60305-5. PMID 18431959.
- ↑ Wilson AM, Orr LC, Sims EJ, Lipworth BJ (2001). "Effects of monotherapy with intra-nasal corticosteroid or combined oral histamine and leukotriene receptor antagonists in seasonal allergic rhinitis". Clin Exp Allergy. 31 (1): 61–8. PMID 11167952.
- ↑ Arasi S, Corsello G, Villani A, Pajno GB (2018). "The future outlook on allergen immunotherapy in children: 2018 and beyond". Ital J Pediatr. 44 (1): 80. doi:10.1186/s13052-018-0519-4. PMC 6042356. PMID 29996875.
- ↑ Dupuis P, Prokopich CL, Hynes A, Kim H (2020). "A contemporary look at allergic conjunctivitis". Allergy Asthma Clin Immunol. 16: 5. doi:10.1186/s13223-020-0403-9. PMC 6975089 Check
|pmc=value (help). PMID 31993069.