Positivity rates of in vitro inhalant/respiratory and food allergy tests in the northern midwestern United States

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Date: Sept. 2018
From: Ear, Nose and Throat Journal(Vol. 97, Issue 9)
Publisher: Sage Publications, Inc.
Document Type: Article
Length: 3,314 words
Lexile Measure: 1760L

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Rates of allergy-test positivity vary by country and by regions within countries. Several studies have looked at allergy test results to determine the most common allergens. Many of these studies have been based on surveys or on studies of small numbers of tests. Positivity rates for allergy tests are poorly defined in the northern midwestern region of the United States. We conducted a study to identify the rates of positive allergy tests for both inhalant/respiratory allergens and food allergens in the upper Midwest. We extracted from our laboratory database the results of all test samples sent for one of eight allergen panels that had been analyzed between Sept. 1, 2014, and Sept. 1, 2015. All testing was performed at The Cleveland Clinic with the Phadia ImtnunoCAP system. The percentage of positive tests, the distribution of the most frequently positive tests, and the class of in vitro responses were identified. A total of 148,628 test results for 63 different allergens were identified. Of the 125,190 tests for inhalant/respiratory allergens, the most frequently positive were dog dander (24% of tests), cat dander (23%), dust mites (23% for both Dermatophagoides pteronyssinus and Dermatophagoides farinae), and June grass (21%). Of the 23,438 food tests, the most frequently positive test results were for milk (18%), peanut (17%), wheat (16%), and egg white (15%). Most of the results fell into classes 1 through 3, although there was still a notable number of very high responses (class 5 and 6). These findings suggest that there is wide variability in the positivity of in vitro allergy tests and that the likelihood of a positive result in screening panels can be estimated. Evaluating such rates will help identify the most and least common allergens and will help to cost-effectively refine allergy screening panels.


Allergic disease is a highly prevalent condition with several clinical manifestations, including allergic rhinitis and sinusitis, allergic dermatologic disorders, allergic conjunctivitis, asthma, and food sensitivities. It is difficult to identify its true prevalence because diagnoses may not be confirmed, studies may be looking at only one of the allergic diseases, and many studies rely on survey responses. When looking at allergic rhinitis, for example, its reported prevalence ranges from 10 to 30% in adults and is as high as 40% in children. (1) There is also evidence that the prevalence of allergies may be increasing, particularly in Western countries. (2)

The diagnosis of allergic disease is based on a classic history with confirmation by allergy testing or response to treatment. Allergy testing can be performed either through skin testing or in vitro (blood) testing for specific IgE directed against potential allergens. (3) Recent clinical guidelines for the management of allergic rhinitis developed by the American Academy of Otolaryngology-Head and Neck Surgery state, "Clinicians should perform and interpret, or refer to a clinician who can perform and interpret, specific IgE (skin or blood) allergy testing for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when the diagnosis is...

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Gale Document Number: GALE|A558921696