Dr Vivek Kumar

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Paper advertisements based blood allergy tests

If you visit a pathology lab for getting diagnosed your diabetes, blood pressure, fever or other health related issues then definitely you should continue.

Ideally you visit a doctor who after listening your symptoms, examined you and advises tests accordingly. You get tested at a pathology lab and meet your doctor with reports. Doctor prescribes medicines correlating your symptoms and reports clinically. An ideal doctor never treats symptoms or reports!

Same way you should visit your nearest allergy doctor for allergy related symptoms who will ask you specific tests according to need. Remember there are different types of allergy tests with different allergens like

1. Skin prick test

2. Specific IgE tests

3. Skin patch tests

4. Intradermal tests

5. Oral challenge tests

6. Prick to prick tests.

Few of these tests can only be performed by a qualified allergist not in a normal lab setting.

Then there are different methods or machines for blood allergy tests.

Immunocap method by phadia is one of the most accepted method world wide but it’s little costly when compared with other acceptable machines like EuroImmune etc.

still blood allergy tests are always costlier when compared with skin prick tests.

Both the tests have their own pro and cons. Both are supplementary to each other not substitutes. Often your allergist will need both.

Contra-indications for Skin prick test:

Patient on anti histamines, pregnancy, beta blockers, few anti psychotic drugs, Un cooperative patients like children.

Average cost of blood allergy tests:

In range of

1500 each, cheaper when done in bulk like 3500 for three allergens, 6500 for ten allergens. It will go in lacs if you blindly check for 100s of allergens. So blood allergy tests are often not advised blindly. Your allergist doctor has to pin point either by history or skin prick test, and if any confusion they will ask you for a small panel or particular allergen.

You should be aware of fake allergy tests going around in market on the basis of full page advertisements in news papers. They will promise a panel of 100s of allergens at a throw away unbelievable price. Like rs 5000 for 100 allergens, it’s impossible to do so by any scientifically accepted machine present in india or abroad.

There are cases where such fake tests were reported, warnings given, forced to return money.

So consult your allergist doctor who specialises in allergy asthma and other allergic diseases before putting your hard earned money in a lab.

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How many allergens to test

There was a time when Allergist’s used to test hundreds of allergens called panels. As gradually science is developing, concept of cross reaction and with availability of community data the list of allergens is getting short.

Doctors who used to test for 220 allergens are now going for less than 40 allergens. Those who are more confident or have pin pointed the allergen by detailed history go for less than 10!

So, the list of allergens to be tested depends on your history, symptoms, frequency like whether perennial or seasonal, indoor or outdoor morning or evening, geographical location etc.

some allergens like dust mites are perennial, while pollens are seasonal. Pollen calendar helps in relating your symptoms with different pollens.

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ABPA

ABPA, i.e. Allergic Broncho Pulmonary Aspergillosis is an often missed cause of shortness of breath

Clue: uncontrolled asthma on high dose ICS-LABA

Diagnosis:

Skin prick test positive to Aspergillus fumigatus or Specific IgE Af more than 0.35

Total IgE more than 1000

Types:

ABPA-S: no lung parenchyma damage

ABPA-CB: Bronchiectasis present

ABPA-CB-ORF: other radiological features also present

Treatment:

Oral steroids

Supportive therapy

Chest physiotherapy

LTOT

Immunisation

Allergen avoidance

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Fake allergy tests

Labs providing allergy reports of smoke, medicines, cosmetics by a mere blood test should caution you for its genuineness.

Do you visit a laboratory or consult a doctor for your fever?

You buy a over the counter medicine by getting your blood pressure checked by pathologist ? If your answer is NO, then you should visit an allergist for any allergy related queries.

allergens act in so many different ways that it needs to be evaluated in individualized manner. Your allergist decides upon the need of investigations after a thorough history.

Lab tests relying on blood investigations can cost you dear creating unnecessary confusion and adding more problems rather solving it.

So, next time you see or hear an ad claiming to reveal your allergy , visit your doctor first !

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Aeroallergens

Allergens are microscopic invisible particles responsible for your allergy symptoms.

Air bound allergens are called aeroallergens. It can be

1. perennial,

2. seasonal or

3. perennial with seasonal exacerbations.

Depending on the allergen to which you are allergic to, symptoms vary accordingly.

Fungal spores or molds are perennial, while pollens are mostly seasonal. Dust mites vary depending on place and climate.

Few insects like mosquitoes and cockroaches can act like aeroallergens too.

Consult an allergist to get your sensitization checked and discuss to find out the allergen responsible.

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