Several types of EIA tests include “ELISA” (enzyme-linked immunosorbent assay) allergy and asthma testing to measures a person's antibody (or immune response). EIA tests are designed to be very "sensitive”, meaning that when they are used properly, almost everyone with Lyme disease will test positive. An allergen-specific immunoglobulin E (IgE) blood test is done to check whether a person is allergic to a particular substance.
An allergic reaction occurs when the immune system overreacts to something, often in the environment, that's harmless to most people. To protect the body from this perceived threat, or allergen, the immune system of an allergic person produces antibodies called immunoglobulin E.
IgE antibodies are found mostly in the lungs, skin, and mucous membranes. They cause mast cells (a type of cell involved in the body's immune response) to release chemicals, including histamine, into the bloodstream. It's these chemicals that bring on many of the allergy symptoms that affect a person's eyes, nose, throat, lungs, skin, or gastrointestinal tract.
Because IgE antibodies are unique to each allergen (for example, IgE produced in response to pollen differs from IgE produced after a bee sting), checking for specific variants in the blood can help determine if an allergy is present.
Common allergens that may be tested for by using the allergen-specific IgE test include:
- animal dander
- dust mites
- foods (including peanuts, milk, eggs, or shellfish)
- medications (such as penicillin)
- insect venom (from bee or wasp stings)
- latex (found in certain balloons or hospital gloves)
Your doctor also may order a group of these tests — sometimes called a mini-screen or mini-panel — to look for antibodies against a variety of suspected allergens.
Skin prick testing or SPT demonstrates an allergic response to a specific allergen. In conjunction with an allergy focused history, SPT can help to confirm the presence of an allergy to either a food or inhaled substance (allergen).
SPT is the most common allergy test performed in an allergy clinic by specially trained staff. SPT is a simple, safe and quick test, providing results within 15-20 minutes. This will enable you to receive a diagnosis and management plan at your appointment.
The skin prick test introduces a tiny amount of allergen into the skin, eliciting a small, localised allergic response, in the form of a wheal (bump) and flare (redness) at the site of testing. These tests can be carried out on all age groups, including babies.
- SPT is usually carried out on the inner forearm, but in some circumstances may be carried out on another part of the body, such as back or thigh. For example, there is a larger area on the back or thigh to perform testing on a baby, similarly, for those with troublesome eczema the test can be performed on any clear patch of skin
- The test allergens are selected following a discussion with your clinician and based on your history
- As few as 3 or 4 or up to about 25 allergens can be tested
- The skin is coded with a marker pen to identify the allergens to be tested
- A drop of the allergen (extract) solution is placed on the skin
- The skin is then pricked through the drop using the tip of a lancet – this can feel a little sharp but should not be painful and should not bleed.
The patient needs to avoid taking anti-histamines and certain other medications before the test. Long acting antihistamines (those that do not cause drowsiness) should be stopped for five days, short acting antihistamines can be stopped 48 hours beforehand. Many cough mixtures contain an antihistamine, therefore please tell the healthcare professional who is performing the test any medication you have taken. The results will not be reliable if anti-histamines are still in the body when the test is performed as antihistamines can prevent the body from reacting to the SPT. If the patient has not stopped taking anti-histamines before their appointment they may not be able to have the skin prick test.
Two control samples are included to make sure that the test has worked; one of the controls will cause a reaction in all people, and the other should not cause a reaction in anyone. This helps the nurses and doctors ensure the test has been conducted properly.
The skin may become itchy within a few minutes and become red and swollen with a “wheal” in the centre (very much like the reaction to a nettle sting). The wheal has a raised edge which slowly expands to reach its maximum size in about 15 minutes, clearing for most people within an hour. Depending upon what you have discussed with your doctor, this may be a ‘positive’ response and your doctor will discuss the results and what they mean for you.
No reaction to the SPT (a negative response) may indicate that the patient is not sensitive to that allergen. Negative reactions may occur for other reasons, for example; if the patient is taking anti-histamines or medications that block the effect of histamine. Which is why it is important the results are interpreted by a healthcare professional experienced in allergy. In some cases, the doctor may request a blood test to help clarify the results.
Lung function tests provide an easy way of measuring the function of the lungs without the need to physically examine the lungs themselves. Lung function or breathing tests are important investigations which:
- Help diagnose suspected lung disease;
- Help in planning treatments and decide whether treatments should be continued,changed, or are no longer needed.
Most lung function tests are straightforward and only involve fairly simple breathing tasks like rapid breathing. This may occasionally be tiring and make you feel a bit puffed, but is usually not uncomfortable.Types of lung function tests
Spirometry and flow volume curves common lung conditions, such as asthma and emphysema, cause problems by narrowing the airways (bronchial tubes) resulting in shortness of breath. Narrowed airways are difficult to breath through -the greater the narrowing, the more difficult that breathing becomes.Spirometry and flow volume curves are tests which are of great value for measuring exactly how much narrowing is present.
Urticaria may be confused with a variety of other dermatologic diseases that are similar in appearance and are pruritic, including atopic dermatitis (eczema), maculopapular drug eruptions, contact dermatitis, insect bites, erythema multiforme, pityriasis rosea, and others. Usually, however, the experienced clinician is able to distinguish these conditions from urticaria because of the lesions' distinctive appearance, the fact that they are intensely pruritic, and because the lesions blanch completely with pressure.
In chronic urticaria, which persists for longer than 6 weeks, a cause is difficult to identify, despite perhaps even exhaustive efforts. This is known as chronic idiopathic urticaria, although most of these cases are chronic autoimmune urticaria, as defined by a positive RAST result.
Sublingual immunotherapy (SLIT) is an alternative way to treat allergies without injections. An allergist gives a patient small doses of an allergen under the tongue to boost tolerance to the substance and reduce symptoms.
An allergist must first use allergy testing to confirm the patient’s sensitivities. Once this is determined, an allergen extract is prepared in drop form or the tablet is prescribed. The patient is directed to keep it under the tongue for one to two minutes and then swallow it. The process is repeated from three days a week to as often as daily with recommendations that therapy is continued for three to five years to develop a lasting immunity.Is Sublingual Immunotherapy Effective and Safe?
Most clinical trials and surveys published over at least 20 years show that SLIT is relatively safe and effective for the treatment of rhinitis and asthma caused by allergies to dust mites, grass, ragweed, cat dander, and tree pollens. Evidence is emerging that SLIT may be effective for treating the red, itchy eyes caused by pollen during hay fever season. In addition, it might prove an effective therapy for children with mild eczema and is currently being studied for its potential in treating food allergies.
Side effects among both children and adults are usually local and mild, most often occur early in treatment, and include itching in the mouth or stomach problems. These can usually be managed by dose adjustments. Very rarely, severe allergic reactions (anaphylaxis) have been reported using SLIT. Therefore this treatment is best prescribed by an allergist.What Are the Risks of Sublingual Immunotherapy?
For the most part, SLIT risks relate to the nature of the treatment: it is administered at home and without direct medical supervision. Patients should therefore receive clear guidance from allergists on managing adverse reactions and treatment interruptions and should know when to consult the prescribing allergist.
A nebulizer changes medication from a liquid to a mist so that it can be more easily inhaled into the lungs. Nebulizers are particularly effective in delivering asthma medications to infants and small children and to anyone who has difficulty using an asthma inhaler.
It is also convenient when a large dose of an inhaled medication is needed. Nebulized therapy is often called a "breathing treatment." And a variety of medications -- both for immediate relief and maintenance of asthma symptoms -- are available for use with a nebulizer.
Nebulizers come in home (tabletop) and portable models. Home nebulizers are larger and must be plugged into an electrical outlet. Portable nebulizers run on batteries -- either disposable or rechargeable -- or can be plugged into a car's cigarette lighter. Smaller, portable units are slightly larger than a deck of cards, so they can be carried in a purse, briefcase, or backpack to be used whenever and wherever you need them.
To obtain a nebulizer, you need a prescription from your doctor, or it can be dispensed from your pediatrician’s office. (Oftentimes, a breathing treatment is administered at the doctor’s office.)
Sputum is a thick fluid made in the lungs and in the airways leading to the lungs. A sputum culture is a test to find germs (such as bacteria or a fungus) that can cause an infection. A sample of sputum is added to a substance that promotes the growth of germs. If no germs grow, the culture is negative. If germs that can cause infection grow, the culture is positive. The type of germ may be identified using a microscope or chemical tests. Sometimes other tests are done to find the right medicine for treating the infection. This is called sensitivity testing.
You may be asked to cough to provide the sputum sample. Some people can't cough deeply enough to produce a sample. They can breathe in a special mist to help them cough.
How To Prepare
Do not use mouthwash before you collect your sputum sample. Some types of mouthwash can kill bacteria and could affect your results.
If bronchoscopy will be used to collect your sputum sample, your doctor will tell you how soon before the test to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
C-reactive protein (CRP) is a substance produced by the liver in response to inflammation. Other names for CRP are high-sensitivity C-reactive protein (hs-CRP) and ultra-sensitive C-reactive protein (us-CRP).
A high level of CRP in the blood is a marker of inflammation. It can be caused by a wide variety of conditions, from infection to cancer. High CRP levels can also indicate that there’s inflammation in the arteries of the heart, which can mean a higher risk for heart attack. However, it’s important to remember that the CRP test is an extremely nonspecific test, and CRP levels can be elevated in any inflammatory condition.
Are there risks with the test?
This is a routine test with low risk, but there’s a slight chance of the following complications from the blood draw:
- excessive bleeding
- dizziness or lightheadedness
- bruising or infection at the puncture site
A CRP test can be helpful in assessing a person’s risk of heart disease, especially in combination with high cholesterol levels. The benefits of this test outweigh potential complications, especially for those at risk for heart disease or stroke and those recovering from recent heart procedures.
As a patient diagnosed with chronic obstructive pulmonary disease (COPD), you are faced with a variety of symptoms.
These range from shortness of breath, fatigue, loss of appetite, wheezing, chronic cough, chest tightness, and excessive mucus (phlegm) production to name a few.
You may not experience all of them but for a large portion of patients, they are faced with an excessive amount of airway blocking mucus production.
Excess and thick mucus (sputum, secretions, phlegm) in your lungs can lead to increased levels of shortness of breath (breathlessness) and higher chances of developing a disease worsening lung infection such as pneumonia.
However, airway secretions can be worsened by certain types of food or drinks, development of a cold or the flu, exposure to extreme weather conditions, COPD exacerbations (flare ups), or even certain types of medications that are used to treat COPD and its related symptoms.
But that doesn't mean you have to put up with worsening lung congestion due to excess mucus production.
When experiencing thick airway secretions, use these 9 mucus clearing techniques to improve the severity of your COPD related breathlessness.
The clinical significance of the type of cells found in nasal secretions relates to the distinction between allergic and non-allergic rhinitis. In nasal discharges due to allergy, the exudates may be purely eosinophilic, or at least eosinophils will be the predominant leukocyte. In contrast, a “runny nose” due to non-allergic causes will either show a predominance of neutrophils or acellular mucus.
- Instruct the patient to blow his/her nose into a piece of wax paper.
- Use a wooden applicator stick to pick up the mucous from the wax paper and spread the secretions thinly onto 2 glass slides, taking care not to traumatize the cells.
- If the patient is too young to blow their nose, or if there is an inadequate sample, use a small nasopharyngeal swab (metal shaft) to collect the specimen. Insert the swab carefully as far up the nasal passage as possible and roll the swab against the septum. Repeat this with the same swab on the other nostril. Roll the swab onto a clean slide making sure to make a thin smear.
- Label the slides and send immediately to the laboratory for testing.
The invention relates to a thermostimulator for heating living tissue in order to produce a pain response, said thermostimulator comprising a controller, a driver, a lighting means, an optical waveguide, and an infrared sensor, wherein the lighting means is a wide-band emitter, wherein the infrared sensor is designed to determine a surface temperature of a target surface at a predefined target distance without contact and to make available the surface temperature thus determined to the controller. The controller is designed to control the lighting means by means of the driver on the basis of the available surface temperature in such a way that a luminous flux exiting the lighting means is directed toward the target surface by means of the optical waveguide, such that a target volume bounded on one side by the target surface can be heated up in such a way that the surface temperature of the target surface deviates from a target temperature by less than 1°C.
About one third of the patients of chronic urticaria have circulating functional histamine-releasing autoantibodies against high-affinity IgE receptor, or less commonly against IgE. Autoantibodies in patients’ serum can be detected by serum-induced histamine release from the basophils of healthy donors by ELISA or Western blot assay. But neither Western blot nor ELISA can differentiate between functional histamine-releasing autoantibody and nonfunctional autoantibody. Moreover, these tests are done only in some specialized centers and they are time consuming to perform. So, a rapid, reliable and in vivo test to distinguish between patients with and those without circulating functional autoantibodies would be of value to diagnose autoimmune urticaria and also to evaluate the effectiveness of immunomodulatory treatment. Intradermal injection of autologous serum in some patients can induce weal and flare response. This observation had led to the recognition of circulating autoantibodies in chronic urticaria and provides the basis of autologous serum skin test (ASST). Sensitivity and specificity of ASST are at best 80% respectively.
- Antihistamines should be withdrawn at least 2 to 3 days prior to the test.
- Doxepin and Astemizole should be withdrawn 2 to 6 weeks beforehand.
- The patient should not take immunosuppressants in the 2 months prior to the test.
- Ethical approval should be taken from the appropriate body.
- Age should be 18 years or more.
- Test area should be free of lesion.
- Two milliliters of venous blood is taken from antecubital vein.
- Blood is allowed to undergo clotting at room temperature.
- Serum is separated by centrifugation (2000 rpm for 10-15 min).
- As much as 0.05 mL of serum is injected intradermally into the volar aspect of forearm, avoiding the areas of wealing within the past 24 h.
- Equal amounts of normal saline [negative control] and histamine (10 μg/mL) [positive control] are injected intradermally 3 to 5 cm apart in the volar aspect of the same forearm.
- Weal and flare responses are to be measured at 30 min. Redness of weal and flare reactions is difficult to perceive in pigmented skin types (e.g., Indian skin). As erythema is contributed almost exclusively by histamine, omitting histamine control in patients of dark skin does not modify the result much. Rather for assessment of the ASST result, weal is much more relied upon.
A skin lesion KOH exam is a simple skin test to check if an infection in the skin is caused by fungus.
KOH stands for potassium (K), oxygen (O), and hydrogen (H). These elements make up potassium hydroxide. Besides the exam, KOH is used in fertilizers, soft soaps, alkaline batteries, and other products.
It’s also known as KOH prep or fungal smear.
Why is a skin lesion KOH exam ordered?
A skin lesion — an abnormal change in the surface of the skin — can have many causes. Your doctor may order a KOH exam if they suspect that a fungus could be the cause of your lesion. Common fungal infections that can be caught by performing KOH examination are ringworm and tinea cruris, commonly referred to as “jock itch.”
Symptoms of a fungal infection that may be detected through a KOH exam include:
- Brittle, deformed, or thickened nails
- itchy, red, scaly patches of skin or scalp
- thrush (white patches in the mouth)
- yeast infection (vaginal discharge and itching)
- Your doctor may also order the test to check on the effectiveness of treatments related to fungal infection.
The test is very simple and carries no significant risks.
How a skin lesion KOH exam is performed
A skin lesion KOH exam requires no special preparation and will happen in an outpatient setting, so you won’t have to spend the night at a hospital. If your doctor is taking a sample from a bandaged piece of skin, the bandages will have to be removed.
During your appointment, your doctor will use the edge of a glass slide or another instrument to scrape off small pieces of skin from your lesion. Your doctor may use a swab to obtain fluid for testing if the lesion is in the mouth or vagina.
These scrapings are then mixed with potassium hydroxide. The potassium hydroxide destroys the healthy skin cells, leaving behind only fungal cells. Normal results of a KOH test will show no fungi present, while abnormal results will tell your doctor that you may have a fungal infection.
What to expect after a skin lesion KOH exam
If the potassium hydroxide destroys all the cells from the sample, it means there’s no fungus present, and your symptoms are most likely being caused by something else. If fungal cells are present, your doctor will begin treatment for your infection.
Antibodies are proteins made by your immune system. They help your body recognize and fight infections. Antibodies normally target harmful substances, such as bacteria and viruses, by activating the immune system to get rid of them.
Sometimes, however, antibodies mistakenly target your healthy cells and tissues. This is known as an autoimmune response. Antibodies that attack healthy proteins in the nucleus (brain) of your cells are called antinuclear antibodies (ANA).
When the body receives signals to attack itself, autoimmune diseases such as lupus (SLE), scleroderma, mixed connective tissue disease, and others can occur. Symptoms vary by disease, but they may include rashes, swelling, arthritis, or fatigue.
While it’s normal to have some ANA, having too many of these proteins will put you at an increased risk for developing an autoimmune disease, such as lupus. An ANA panel helps determine the level of ANA in your blood. You may have an autoimmune disorder if the level is too high.
Do I Need to Prepare for the Test?
There is no preparation needed for the ANA panel. However, it’s important to tell your doctor about any medications or supplements that you’re taking, even over-the-counter ones. Some drugs can affect the accuracy of the test.
Autoimmune thyroid disease, including Hashimoto disease and Graves disease, is characterized by lymphocytic infiltration. Animal studies have shown that B lymphocytes in the thyroid gland are the major source of antithyroid antibodies. As described above, 3 major thyroid antibodies exist: TPOAb, TgAb, and TRAb.
TPOAb and TgAb are polyclonal antibodies of the immunoglobulin G (IgG) class. They have a complement fixing and cytotoxic capacity, but their role in Hashimoto disease still is not clear and seems to be a response to thyroid injury.
TRAb are divided into 3 types: stimulating, blocking, and neutral antibody in relation to the thyroid function. The stimulating TRAb are oligoclonal antibodies of the immunoglobulin G1 (IgG1) subclass. TRAb bind to TSH receptors and activate the signaling pathway. They can induce thyroid growth, as well as thyroid hormone production and secretion; this finding suggests that TRAb are the primary cause of Graves disease.
It is now believed that Graves disease and Hashimoto disease are closely related. In Graves disease, the goiter can result from TSH receptor stimulation, whereas, in Hashimoto disease, it results from lymphocytic infiltration, causing follicular cell destruction.
Complement C3 is a blood test that measures the activity of a certain protein that is part of the complement system. The complement system is a group of proteins that move freely through your bloodstream. The proteins work with your immune system and play a role in the development of inflammation.
There are nine major complement proteins. They are labeled C1 through C9. This test measures C3.
How the Test is Performed
Blood is drawn from a vein. Most often, a vein from the inside of the elbow or the back of the hand is used. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
How to Prepare for the Test
There is no special preparation needed.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the Test is Performed
C3 and C4 are the most commonly measured complement components.
A complement test may be used to monitor people with an autoimmune disorder and to see if treatment for their condition is working. When the complement system is turned on during inflammation, levels of complement proteins may go down. For example, patients with active lupus erythematosus may have lower-than-normal levels of the complement proteins C3 and C4.
Complement activity varies throughout the body. For example, in people with rheumatoid arthritis, complement activity in the blood may be normal or higher-than-normal, but much lower-than-normal in the joint fluid.
The test may also be done for the following conditions:
- Fungal infections
- Gram negative septicemia
- Parasitic infections, such as malaria
- Paroxysmal nocturnal hemoglobinuria (PNH)
Thyroid-Stimulating Hormone (TSH)
A thyroid-stimulating hormone (TSH) blood test is used to check for thyroid gland camera.gif problems. TSH is produced when the hypothalamus releases a substance called thyrotropin-releasing hormone (TRH). TRH then triggers the pituitary gland camera.gif to release TSH.
TSH causes the thyroid gland to make two hormones: triiodothyronine (T3) and thyroxine (T4). T3 and T4 help control your body's metabolism.
Triiodothyronine (T3) and thyroxine (T4) are needed for normal growth of the brain, especially during the first 3 years of life. A baby whose thyroid gland does not make enough thyroid hormone (congenital hypothyroidism) may, in severe cases, be mentally retarded. Older children also need thyroid hormones to grow and develop normally.
This test may be done at the same time as tests to measure T3 and T4.
Why It Is DoneA test for thyroid-stimulating hormone (TSH) is done to:
Find out whether the thyroid gland is working properly.
- An underactive thyroid gland (hypothyroidism) can cause symptoms such as weight gain, tiredness, dry skin, constipation, a feeling of being too cold, or frequent menstrual periods.
- An overactive thyroid (hyperthyroidism) can cause symptoms such as weight loss, rapid heart rate, nervousness, diarrhea, a feeling of being too hot, or irregular menstrual periods.
- Find the cause of an underactive thyroid gland (hypothyroidism). TSH levels can help determine whether hypothyroidism is due to a damaged thyroid gland or some other cause (such as a problem with the pituitary gland or the hypothalamus).
- Keep track of treatment with thyroid replacement medicine for people who have hypothyroidism.
- Keep track of thyroid gland function in people who are being treated for hyperthyroidism. This treatment may include antithyroid medicine, surgery, or radiation therapy.
- Double-check the diagnosis of an underactive thyroid gland in a newborn (congenital hypothyroidism).
How To Prepare
Tell your doctor if you have had any tests in which you were given radioactive materials or had X-rays that used iodine dye within the last 4 to 6 weeks. Your test results may not be correct if you have had iodine contrast material before having a thyroid-stimulating hormone (TSH) test.