Objective: The primary objective of this report was to discuss the accuracy of specific immunoglobulin (Ig)E antibody determinations in the diagnosis and prognosis of reactions to allergens, especially cow's milk, in the context of other relevant clinical information.
Data sources: A review was undertaken of the relevant literature on IgE antibody assays in conjunction with some unpublished information from the authors' investigations.
Study selection: The pertinent data for this article were selected on the basis of the expert opinion of the authors.
Results: IgE antibody formation and allergy commence early in life, which can be reflected by specific IgE antibody determinations in serum samples with use of particular systems developed for commercial use. After the first such system was introduced in 1974, development of the technology has ensued. Some systems using excess of allergen extracts of good quality have proven to yield highly accurate results over time. Assays that detect all antibodies present in the serum sample and that demonstrate parallelism between dilutions of specific IgE antibodies and total IgE concentration also allow quantitative determinations of specific IgE antibodies. Such specific IgE antibody data can be used not only for a dichotomized evaluation of the presence or absence of sensitization in an individual patient, but also for an evaluation of the relative risk for a clinical reaction to an allergen such as cow's milk. Thus, the specific IgE antibody information can be used in the diagnosis, prediction of the course, and followup management of allergic disease, particularly when sensitization to multiple allergens is present.
Conclusions: Specific IgE antibodies can be accurately determined with certain technologic systems. Such determinations provide information, not available by other means, for the diagnosis, prognosis, and followup of patients with allergy-like symptoms.