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]] | ||
*Ambiguous results (e.g., presence of [[dermatographism]]) | |||
*To complement the results of previous [[skin]] testing. | |||
===[[Conjunctival]] [[allergen]] challenge=== | ===[[Conjunctival]] [[allergen]] challenge=== | ||
* It involves instillation of an [[allergen]] on the [[conjunctiva]] of the affected [[eye]] and a control solution in the other [39]. | * It involves instillation of an [[allergen]] on the [[conjunctiva]] of the affected [[eye]] and a control solution in the other [39]. | ||
Revision as of 04:07, 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
- Ambiguous results (e.g., presence of dermatographism)
- To complement the results of previous skin testing.
Conjunctival allergen challenge
- It involves instillation of an allergen on the conjunctiva of the affected eye and a control solution in the other [39].
- More common in research settings to test novel treatments or to compare existing therapies
- Clinically helpful to identify local allergies in suspect patients but with negative or discordant skin prick testing and serum specific IgE [29]. *Useful to assess the relationship between symptoms and exposure in polysensitized patients and the response to initiated therapy.[29, 39].
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.