Apport de la biologie dans le diagnostic d’allergie immédiate

Abstract

Immediate allergy has various clinical manifestations and can create difficulties during the diagnostic to properly identify the responsible allergen and monitor the disease. To help the allergologist, the biologist can offer lab tests to confirm the nature of the allergen and to better molecularly define it through analysis of the components recognized by patient IgEs. This strategy allows diagnosis confirmation, risk assessment and potential cross-reaction identification. Component analysis is also helpful to set up and monitor specific allergen immunotherapy. In anaphylactic reactions, measuring mediator release (tryptase and histamine if necessary) can confirm mastocyte and/or basophil activation, the triggering agent being identified later. Ready-to-use blood sampling kits may make the procedure easier in an emergency. In the event of an uncertain diagnosis and if suspected allergen exposure in a provocation test is too harmful for the patient, functional tests can be performed in vitro using patient blood basophil in complete safety.Biologic tests can therefore contribute to the clinician’s diagnosis. It should be conducted in a complete partnership in order not to cast doubt in the case of IgE detection, which remains a common situation, unlike allergy that is a disease with potential serious complications.