Information Related to Pediatricians

Allergy testing is a screening procedure that aims to detect whether the patient's body has an allergic reaction to certain substances or substances (allergens). Allergy testing can be done in the form of blood tests or skin tests. This examination procedure is usually performed by a consultant allergist.

Allergies occur when the body's immune system overreacts to allergens in the environment. Allergic reactions the body produces can range from mild symptoms to anaphylactic reactions that can be life-threatening. Common mild allergic reactions include sneezing, nasal congestion, itching, and runny eyes and nose.

Types of Allergy-Causing Substances (Allergens)

Allergens are substances, substances, or substances that cause allergies. allergy. Generally, there are three types of allergens, namely:

• Inhaled allergens. Allergens that can trigger an allergic reaction in the body when inhaled and interact with the lining of the nose, throat or lungs. Allergens classified as inhaled allergens include pollen, dust and animal dander.
• Contact allergens. Allergens that can trigger allergic reactions in the body when they interact with the skin. Insect stings and chemicals, such as latex, are some examples of contact allergens.
• Gastrointestinal allergens. These types of allergens are commonly found in foods, such as nuts, seafood, or soy. Apart from food, drugs such as the antibiotic penicillin are also gastrointestinal allergens. Drug allergies can occur in adults as well as children.

Indications for allergy testing

Allergies can happen to anyone, but generally more susceptible to occur in children and people who have a family history of allergies, such as asthma or eczema.

Allergy testing can be done through the skin or taking a blood sample. But skin allergy testing is the more common method of testing. This test aims to detect the type of allergen that causes allergies in the patient's body. A skin allergy test is performed on someone who is suspected of having an allergy to certain substances (for example animal dander or food), which causes a person to suffer from allergic rhinitis, asthma, dermatitis, or swelling under the skin (angioedema).

Warning

Please be careful when doing allergy skin testing in the following conditions:

• Patients under 2 years of age. Consult your doctor first because skin allergy testing has a greater risk if it is performed on children under 2 years of age.
• Patients who are new or experiencing allergic reactions, especially recently anaphylactic reactions. Skin allergy testing should only be done 4-6 weeks after the patient experiences an anaphylactic reaction. This condition can cause inaccurate test results.
• The patient suffers from certain skin disorders, such as eczema or psoriasis. This skin condition can affect the structure of the skin cells and cause allergy testing to be inaccurate. Skin allergy testing should be done under normal skin conditions.
• Patients with medical conditions, such as heart problems or asthma.
• Patients who are taking drugs that can affect the results of allergy tests , such as antihistamines and corticosteroids, as well as other drugs such as ranitidine, tricyclic antidepressants, and beta-blocker drugs.
• Elderly patients (& gt; 65 years). Allergy skin testing performed on elderly patients should be done with caution because the skin and body responses tend to be more sensitive.

If a skin allergy test is not possible, the doctor will perform an allergy test through a blood sample. This type of allergy test is generally safe to do, including in patients with skin disorders as well as in children under 2 years of age. Blood allergy tests are also safe for patients who are taking antihistamine drugs so that patients do not need to make special preparations before undergoing this allergy test. However, there are some drawbacks to blood allergy testing, including:

• The cost is more expensive than the allergy test through the skin.
• The process of analyzing blood samples takes a long time, so The test results generally only come out after a few days or a few weeks.
• Less sensitive than a skin allergy test because it cannot determine the type of allergen.

Before the Allergy Test

Before the patient is tested for allergy, the doctor will check the patient's medical history. At this stage, the doctor will ask for a history of complaints, questions related to lifestyle and daily activities, as well as family medical history, especially a history of allergies. After that, the doctor will perform a physical examination to look for additional clues regarding signs of allergies.

The doctor may also recommend stopping certain medications 10 days before the allergy test is done. These types of drugs include:

• Antihistamine drugs.
• Ulcer drugs, such as cimetidine and ranitidine .
• Asthma medication omalizumab.
• tricyclic antidepressant drugs, such as amitriptyline.

Types and Allergy Test Procedures

There are several types of allergy tests that are commonly performed to determine allergens, including skin allergy testing, blood allergy testing, and elimination diet.

Skin allergy test

• Skin prick test. This is the most common type of allergy test. The following is an allergy test procedure through a skin prick:
  • The doctor will clean the skin on the patient's upper or lower arm with alcohol.
  • After cleaning, the doctor will mark the skin with a marker or pen .
  • The doctor will drop a certain amount of solution (up to 10-12 drops) at each mark you make. The solution is a mixture of liquid and allergen. Each solution contains a different allergen.
  • The doctor will prick the area of ​​the skin where the solution has been dripped with a very thin needle so that the allergen can get under the surface of the skin.
  • The doctor will watch for signs of allergies may appear on the skin. An allergic reaction will generally appear within 15-20 minutes.

• Intradermal skin test ( intradermal skin test ). This skin test is performed if the skin prick test shows negative results, but doctors still suspect that the patient has an allergy to an allergen. The following is the intradermal skin test procedure:
  • After the patient's skin is cleaned with alcohol, the doctor will inject a small amount of the allergen into the skin layer.
  • The doctor will monitor any allergic reactions that may appear on the patient's skin. An allergic reaction will generally appear within 15-20 minutes.

• Patch testing. Patch testing is generally performed to detect substances or allergens causing skin irritation (contact dermatitis) in patients. These allergens can be metal, plastic, or rubber. Following is the patch testing procedure:
  • The doctor will clean the upper back of the patient with alcohol.
  • After cleaning, the doctor will put a type of adhesive that has been filled with 20- 30 substances or allergens that cause contact dermatitis.
  • After 2 days, the doctor will check if there is an allergic reaction caused by any of the allergens that were applied.
  • The doctor will perform a two-day check again then to detect if there is a delayed allergic reaction.

Blood allergy test

Allergy test via blood is generally used if the patient is concerned that he will experience a severe allergic reaction to an allergy skin test. A blood allergy test is done by checking immunoglobulin E (IgE) in the blood. Immunoglobulin E (IgE) is an antibody produced by the immune system to fight substances that are considered a threat to the body. When the body experiences an allergic reaction, the amount of IgE will increase. The measured IgE can be the amount of all IgE antibodies in the body ( total IgE test ) or the IgE antibody response rate to an allergen ( specific IgE test ). A blood allergy test begins by taking a blood sample, then the blood sample will be checked into the laboratory for analysis.

The blood allergy test procedure generally takes less than 5 minutes, but it can take several days for the test results to come out.

Elimination Diet

An elimination diet is generally used to detect food allergies in patients. The elimination diet procedure is divided into two phases, namely:

• The elimination phase. This phase is done by avoiding the consumption of suspected foods. trigger allergy symptoms. Some foods that are generally avoided include nuts, milk, eggs, and seafood. In this phase, the patient can detect whether the allergy symptoms are caused by food or something else. The elimination phase lasts for 2-3 weeks.
• The reintroduction phase. This phase involves re-consuming foods that were previously avoided regularly. slowly. During the reintroduction phase, the patient or doctor can watch for possible signs of an allergy, such as a rash, flatulence, or shortness of breath. If these signs appear, the cause of the allergy has been identified and the patient is advised to avoid consuming these types of food.

The whole process of elimination diet generally takes 5-6 weeks. Talk to your doctor or nutritionist before starting an elimination diet. Eliminating too much food can cause the body to lack nutrients.

After an allergy test

Allergy test results can be found in minutes to days. The results of allergy skin tests, namely prick test and intradermal skin test, can generally be found in just a few minutes. The test result is positive when the skin becomes red, itchy, and a small white spot appears around the test area. These white spots will disappear after a few hours. The test result is said to be negative when the skin remains in its normal condition. This condition indicates that the patient is not allergic to any allergens.

Blood allergy test results generally take several days to go through the analysis process in the laboratory. If the test results show that the total IgE in the body is higher than normal, the patient may have an allergy. However, the total IgE test is considered less sensitive when compared to the allergy skin test, and the total IgE test does not reveal the type of allergen that causes the allergy. To find out, the patient can run a specific IgE test.

Once the allergen is identified, the doctor will determine an allergy treatment plan, including avoiding contact with allergens and drugs.

Some steps that can be taken done to prevent contact with allergens, including:

• If you have a food allergy, check the composition of packaged or canned food before eating.
• Clean bed and change sheets or bedding regularly.
• Clean carpets regularly, or avoid using carpets, especially if you have pets.
• Keep humidity in the house with a ventilation system
• If possible, use air conditioning as it can reduce the development of mold and dust populations.
• Keep pets out of the bedroom and clean pets regularly.

Complications of Allergy Testing

Every common screening procedure has risks, including allergy testing. Some of the common side effects that may appear after an allergy test include:

• Itching.
• Reddened skin.
• Swelling in the examination area.
• Small spots appear on the skin area
• Pain at the injection site.
• Light bleeding at the injection site.

Minor side effects this generally goes away within hours or after a few days. The use of corticosteroid creams may be suggested to alleviate side effects.

In some rare cases, an allergy test can produce a severe allergic reaction and requires emergency medical attention. One of them is anaphylaxis, which is a severe allergic reaction that can be life-threatening to the patient. Anaphylactic reactions are characterized by several signs and symptoms, including:

• Nausea, vomiting, or diarrhea.
• Dizziness.
• Weak and fast heart rate .
• Skin reactions, which include itching and redness.
• Narrowing of the airways and swelling of the throat or tongue, which makes it difficult for the patient to breathe.

If an anaphylactic reaction occurs after leaving the hospital or arriving at home, contact your doctor immediately for emergency treatment.

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