* Different Color coding for different type of Allergen
The first step in being able to optimally treat any allergy is getting a definitive diagnosis.
Careful history-taking and physical examination are of utmost importance in the diagnosis of allergic disorders. The patient’s history is used to determine the severity of the condition, the presumed degree of sensitization and the suspected allergens. Quite often allergic symptoms and their temporal occurrence help to identify eliciting agents (allergens) which have to be confirmed by further specific testing. Based on history and physical examination suspected allergens are tested in vivo and/or in vitro to confirm or to rule out lgE mediated hypersensitivity.
Based on history and physical examination suspected allergens are tested in vivo and/or in vitro to confirm or to rule out lgE mediated hypersensitivity. In case of doubt nasal or bronchial provocation testing may be performed.
Skin Testing is comparatively simple and inexpensive method of diagnosis, which is easy to perform and the result are available within half an hour. In this Process the patient is also able to see the inflammatory response to the positive skin test and appreciate the differential in severity of the allergens.
For successful treatment of patients with respiratory allergic disorders, it is essential that the allergens causing the symptoms are accurately identified. there are different ways to arrive at a diagnosis. The clinical history is extremely important in all allergy investigations. Based on the patient’s symptoms, the doctor can decide to carry out various laboratory skin tests, provocation tests or more likely a combination these
The Case history should form the basis of all allergy investigations, which gives the doctors an idea of a causative allergens. The doctor questions the patient or asks him to fill in a questionnaire. It is important to know, when and how the symptoms develop. Also important is the relationship with season, damp weather, physical activity and certain foods, etc. A knowledge of personal habits such as smoking. occupation, hobbies, the pets or fitted carpets etc.
The basis of allergic diagnosis is a through and detailed case history. The case history enables the clinician firstly to assess the importance of allergy as an etiological factor, and secondly, to recognize those allergens which are the probable cause of the patient’s condition. Some allergic condition can be identified relatively easily from the case history. Classsical hay fever and grass pollen asthma, for example, have a clear-cut pattern of symptoms which can be related to the incidence of grass pollens in the atmosphere. Similarly, many cases os asthma and perennial rhinitis may be caused by, or complicated by allergy to the house dust mite. A correlation of the frequency and severity of attacks with the incidence of the house dust mite in the patient’s environment will help considerably in the correct diagnosis of the condition
Skin Testing is comparatively simple and inexpensive method of diagnosis, which is easy to perform and the result are available within half an hour.
Age many help to indicate whether allergy is involved in the patient’s condition Occupation may be very significant, since materials contracted or inhaled at work may cause allergic reactions.
Allergic patient are likely to have a personal ans/or family history of allergy. a variety of allergic symptoms may appear at different ages, e.g.a patientmay have eczema as a baby, hay fever as a child and asthma as an adult.
Allergic asthma attacks are characteristically episodic, severe, of sudden onset and short duration
Answers to this section may indicate whether the patient has come into contact with new inhalants or contactants as a result of an environmental change
Questions in this section are designed to indicate the more important allergens implicated in the patients condition.
The patient should avoid anti-histamines and tranquilizers for 48-72 hours and other sympathomimetic drug such as ephedrine, adrenaline, isoprenaline, salbutamol, etc. for about 8 hours prior to the time of allergen skin tests. Although experiment have shown that the influence of the sympathomimetics on skin tests start wearing off after an hour or two, It is better to avoid them for a longer period.
Long acting antihistamines such as astemizole should be stopped at least for your weeks. Prick test is preferred for initial testing because it is more rapid, less painful and the glycerinated extracts, used are more stable, However, prick test can give false negative results, if not performed properly. Least for your weeks. Prick test is preferred for initial testing because it is more rapid, less painful and the glycerinated extracts, used are more stable, However, prick test can give false negative results if not performed properly.
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Late Sh. Nirankar Sharma Ji
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