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PATIENT INFORMATION After obtaining your medical history, your doctor will conduct a physical exam. He or she will look in your eyes, ears, and nose, examine your throat, and listen to your breathing. Next, your doctor will perform some tests to confirm what was learned through your history and physical exam. Allergy tests include skin tests, challenge tests, and blood tests, among others. •• Skin (prick or scratch) tests and challenge (food) tests are usually performed in the office of a doctor who specializes in diagnosing and treating allergies (allergist). These tests involve exposing you to suspected allergens to see if they cause allergic reactions. •• Blood tests are performed in a lab, and they check the presence and amount of IgE antibodies to any suspected allergen(s) in your blood sample. The test may look for IgE antibodies to a single allergen, like cat dander, or a group (panel) of allergens, such as food allergens or inhaled allergens that are common to the area where you live. Blood testing can tell your doctor if you have allergies and, if so, what you are allergic to. This is may be a good approach for testing babies and young children so their allergies can be identified and managed at an early stage. By looking at the completed puzzle—the results of your history, physical exam, and allergy tests—your doctor will know what triggers your allergies and can create a customized treatment plan that may prevent long-term health problems. Your treatment plan may include one or more of the following4,8: •• Strictly avoiding allergy triggers. •• Taking medication to relieve symptoms, such as a stuffy nose or difficulty breathing. •• Receiving allergy shots (immunotherapy) to help your immune system become less sensitive to the problem allergen(s). Allergies and Asthma Early sensitization to allergens is associated with the later development of asthma.7 When you are sensitized to an allergen (like dust mites) and then exposed to this allergen later in life, it may trigger an asthma attack. Allergies can trigger asthma attacks in 60-90 % of children and in 50% of adults.9 Among the most common allergens are house dust mite, grass pollen, cat dander, and A alternata (plant fungus).3 A blood test to determine your IgE levels to these types of allergens is helpful to assess your sensitivity. Once the allergen(s) that cause your symptoms are determined, steps can be taken to help you avoid what you are allergic to and help your doctor decide what, if any, medications you may need.7,8 References 1. Asthma and Allergy Foundation of America. Allergy overview. AAFA Web site. http://www. aafa.org/page/allergies.aspx. Accessed April 10, 2017. 2. Fairfax Neonatal Associates, PC - A Neonatal & Pediatrics Subspecialty Group. Allergy and Immunology FAQ. Available at: https://www.fnapc.com/specialties-services/pulmonologyallergy/allergy-and-immunology/allergy-and-immunology-faq/. Accessed April 10, 2017. 3. Arshad SH, Tariq SM, et al. Sensitization to common allergens and its association with allergic disorders at age 4 years: a whole population birth cohort study. Pediatrics. 2001;108(2):E33. 4. American College of Allergy, Asthma, and Immunology. Allergies. ACAAI Web site. http://acaai.org. Accessed April 11, 2017. 5. Wahn U. The allergic march. World Allergy Organization Web site. http://www.worldallergy. org/professional/allergic_diseases_center/allergic_march/. Accessed April 10, 2017 6. Zheng T, Yu J, Oh MH, Zhu Z. The atopic march: progression from atopic dermatitis to allergic rhinitis andasthma. Allergy, Asthma, and Immunology Research. 2011;3(2):67-73. 7. Wickman M. When allergies complicate allergies. Allergy. 2005;60 Suppl 79:14–18. 8. Wallace CV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: An updated practice parameter. J Allergy ClinImmunol. 2008;122:S1–S84. 9. Kelly WF, Kaliner MA, et al. Allergic and environmental asthma overview of asthma. Available at: http://emedicine.medscape.com/article/137501-overview. Accessed March 28, 2017. Note: This material is provided for general information purposes only. It is not intended as a substitute for medical advice and/or consultation with a physician or technical expert. ©2017 Laboratory Corporation of America® Holdings All rights reserved. L575-0517-7 Allergies What are Allergies? Allergic diseases such as eczema, seasonal allergies, nut allergies, and allergic asthma, are common health problems. Allergy symptoms may be bothersome, yet manageable for some people. Others may be made miserable by their symptoms or may even be at risk for life-threatening reactions. Allergies can also lead to other health conditions, such as asthma, and/or complicate others, including recurring ear and sinus infections. Allergy Causes and Symptoms Allergies develop when your immune system — your body’s natural defenses — identifies an allergen as a foreign substance and attacks it. The allergen can be something you breathe in, eat, touch or get through an insect sting.1-3 •• The first time you are exposed to the allergen your immune system makes immunoglobulin E (IgE) antibodies and releases them into your bloodstream to defend your body against the allergen. This is called sensitization. •• Each thing your body identifies as an allergen will produce its own antibodies, so if your body identifies ragweed as an allergen it will create antibodies specific to ragweed. •• After you become sensitized, your body will create allergen-specific antibodies to ragweed every time you are exposed to it. Over time you will build up ragweed-specific IgE antibodies until you go beyond your allergen threshold and start having allergy symptoms. Depending on the allergen, allergy symptoms vary and may include skin rash, headache, sneezing, runny nose, swelling, nausea, and diarrhea. Anaphylaxis, the most severe reaction, can be life threatening.4 Allergens that:4 •• are breathed in (inhaled) may cause sneezing; stuffy or •• •• •• runny nose; red, itchy or watery eyes; itching; wheezing, coughing, tightness in the chest; or shortness of breath. come in contact with skin may cause hives or rashes. are swallowed may cause itching or swelling of the lips and/ or tongue, tightness in the throat, abdominal pain, nausea and vomiting, and diarrhea. Skin rashes or anaphylaxis may also develop. bite or sting, such as insects, may cause pain, redness, itching, hives and swelling at the site of the bite or sting. Anaphylaxis may also occur. Who Gets Allergies? Allergies tend to be passed down from parents to their children (inherited), and your risk of developing allergies is greater if both of your parents have them than if only one parent has them.2,5,6 You may develop some or all of the same allergies your parents have or completely different ones.2 Allergic diseases usually first appear in childhood. Studies suggest that some allergy-prone children develop a series of specific allergies at certain ages. This “allergic march” usually starts with eczema appearing during the first 1-3 years of life, followed by allergic rhinitis (inflammed nasal mucosa), and finally asthma.5-7 Some children completely outgrow allergies, while others outgrow some allergies but not others.2,3,6 Diagnosing and treating allergic diseases as early as possible in young children may stop the allergic march and may make it less likely that a child will develop asthma.6-8 How Are Allergies Diagnosed? Not all symptoms associated with allergies are caused by allergens. It is important for your doctor to know whether your symptoms are the result of an allergic response and, if so, exactly what triggers your symptoms so you can receive proper treatment.8 Finding the cause of your allergic symptoms is like working a puzzle. By themselves, the pieces do not mean much, but together they form a complete picture. First, your doctor may determine your medical history by asking questions such as: •• When did your symptoms start — in childhood, your teen years, or adulthood? •• Do you have problems only during certain months? •• Are your symptoms better or worse during the day or night, indoors or out? •• Do any of your relatives have allergies? •• Do you have pets? Your doctor will also want to know about foods you frequently eat, like eggs or milk. Your answers to these and other questions will give clues as to what your problem might be.