Important Considerations in the Interpretation of Diagnostic Testing in Allergy

The diagnosis of immunoglobulin E (IgE)-mediated allergy is challenging because the presence of allergen sensitization often does not correlate with clinical reactivity. Diagnostic testing is most useful when the clinical history suggests a moderate probability of allergy. Skin test and allergen-specific IgE are first-line tests, and component resolved diagnostics, bead-based epitope assays, and basophil activation tests can improve diagnostic accuracy. Finally, biologics and other therapies can affect testing accuracy and should be taken into consideration when interpreting results.