Diagnostik ved mistanke om immunglobulin E-medieret allergi

The aim of this paper is to provide primary health care physicians with practical guidelines for allergy testing. Allergy diagnosis rests on a firm medical history, physical examination and allergy testing. The allergy tests of choice are the skin prick test (SPT) and measurement of specific IgE (s-IgE), which in most cases are sufficient. Furthermore, these tests are safe and available in primary health care facilities. However, they cannot be used as an objective measure of disease severity and should always be regarded as a supplement to the history, not vice versa. Specialists should perform most other tests, including intracutanous skin testing and allergen challenge tests (essential to identifying the culprit food or drug allergen), as well as in vitro tests such as cellular function/liberation assays (histamine liberation test, basophil activation test, cellular activation test). These last are used when a suspected allergen is not commercially available for SPT or s-IgE testing, e.g., food, drug, or environmental allergens. We present a simple flow chart for allergy investigation in primary health care.