Pediatrics: あらためてアレルギー検査過剰検査や偏重診断に自重を求める

Pediatrics の2012年1月号に予定のようだ

Robert Wood ( Johns Hopkins Children's Center) と Scott Sicherer ( Mt. Sinai Hospital )のアレルギー学の指導的立場の2人から、アレルギー検査オーダー時の注意点と、診断において、これらのみを重視してはならないという助言が記載されるとのこと。

In their report, the scientists say, skin and blood tests can and should be used to:

Confirm a suspected allergic trigger after observing clinical reactions suggestive of an allergy. For example, children with moderate to severe asthma should be tested for allergies to common household or environmental triggers including pollen, molds, pet dander, cockroach, mice or dust mites.
Monitor the course of established food allergies via periodic testing. Levels of antibodies can help determine whether someone is still allergic, and progressively decreasing levels of antibodies can signify allergy resolution or outgrowing the allergy.
Confirm an allergy to insect venom following a sting that causes anaphylaxis, a life-threatening allergic reaction marked by difficulty breathing, lightheadedness, dizziness and hives.
Determine vaccine allergies (skin tests only).

Conversely, skin and blood tests should NOT be used:

As general screens to look for allergies in symptom-free children.
In children with history of allergic reactions to specific foods. In this case, the test will add no diagnostic value
, the experts say.
To test for drug allergies. Generally, blood and skin tests do not detect antibodies to medications.



Warning: Food Allergy Blood Tests Sometimes Unreliable 
July 17, 2007

目新しいのもではないが、屋内アレルゲン回避行動に介して臨床的ベネフィットは一般的に確立しておらず、報告があるとしても非浸透性のベッドカバーのみ(GINA 2010 Figure 4.2-1)



by internalmedicine | 2011-12-27 08:59 | 環境問題  

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