[Diagnosis of respiratory allergic diseases]

Personal experience acquired at the allergology polyclinic of the Zurich University dermatological clinic is referred to in an account of the path leading from the provisional diagnosis of respiratory syndrome (rhinopathy and bronchial asthma) to a specific aetiological diagnosis, and hence to treatment of the cause (elimination of the allergen, hyposensitisation management). Careful investigation of the allergological history and skin tests (prick test) and scarification, using the patient's environmental allergens, such as household and occupational dusts, or intradermic tests, are the mainstay of diagnosis, especially in sensitisation to pneumoallergens, in spite of the introduction of RIST or PRIST radioimmuological assay of total IgEs, or specific sensitisation to known allergens (RAST method). The RAST, however, has become a sound and indispensable secondary aid, to be carried out before provocation tests, these being not entirely free of risk. Knowledge of the local pollen calendar is a necessary prerequisite to a diagnosis of pollinosis.