What is alternaria alternata m6 ige allergy
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Childhood Allergy Profile with Reflexes
82785, 86003 (x16)
IgE allergy testing for:
Cat Dander (e1)
Cow’s Milk (f2)
Dermatophagoides farinae (d2)
Dermatophagoides pteronyssinus (d1)
Dog Dander (e5)
Egg White (f1)
Mouse Urine Proteins (e72)
If Egg White (f1) IgE is ≥0.10 kU/L, Egg Component Panel will be performed at an additional charge (CPT code(s): 86008 x2).
If Cow’s Milk (f2) IgE is ≥0.10 kU/L, Milk Component Panel will be performed at an additional charge (CPT code(s): 86008 x3).
If Peanut (f13) IgE is ≥0.10 kU/L, Peanut Component Panel will be performed at an additional charge (CPT code(s): 86008 x5).
5 mL serum
Plastic screw-cap vial
Room temperature: 14 days
Refrigerated: 14 days
Frozen: 30 days
Set up: Mon-Sat a.m.; Report available: Next day
See Laboratory Report
The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only.
CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.
Patients with IgE-mediated allergies may present with one or more of a wide range of non-specific symptoms including bronchospasm, rhinitis, conjunctivitis, recurrent otitis media, urticaria, eczema, angioedema, pruritus, colic, nausea, abdominal pain, vomiting, diarrhea, or anaphylaxis.
Such symptoms can also be consistent with viral and bacterial infections, medication side-effects, occupational irritants, hormones, emotional stress, etc. A definitive allergy diagnosis allows selection of appropriate therapies such as immunotherapy or allergen avoidance and circumvents use of unnecessary medication (eg, antibiotics) and unnecessary, costly, inconvenient, or potentially harmful (eg, food avoidance) avoidance measures.1 A definitive allergy diagnosis can also enable improved management of comorbid conditions such as asthma.2 Additionally, early allergy diagnosis and treatment may delay or prevent development of asthma in children.3-5 Thus, overall patient healthcare can be improved, leading to reduced morbidity and a higher quality of life.
Specific IgE allergen testing has been used clinically to law in or law out atopy in patients with allergy-like symptoms, identify the allergen causing the patient’s symptoms, and to assess current sensitivity/tolerance to the allergen in previously diagnosed patients.
Skin testing has historically been the preferred method owing to higher sensitivity.6 However, the Joint Task Force on Practice Parameters, composed of the 3 national allergy and immunology societies, considers both skin testing and in vitro IgE tests to own sufficient sensitivity to assist law out IgE-mediated food allergies.7 Moreover, there are certain circumstances in which an in vitro test should be used instead of a skin test6:
- Lawrence, DP; Park, MS; Pryor, BM (2012).
«Nimbya and Embellisia revisited, with nov. comb. for Alternaria celosiae and A.
perpunctulata«. Mycological Progress. 11 (3): 799–815. doi:10.1007/s11557-011-0793-7.
- Lawrence, DP; Gannibal, PB; Peever, TL; Pryor, BM (2013). «The sections of Alternaria: formalizing species-group concepts». Mycologia. 105 (3): 530–546. doi:10.3852/12-249. PMID 23687125.
- Asan, A (2015). «Checklist of Alternaria Species Reported From Turkey». Mantar Dergisi. 6 (2): 43–57. doi:10.15318/Fungus.2015214064.
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Skin prick testing
The panel of SPT extracts comprised a variety of perennial (cat, dog, dust mite, cockroach and mouse), grass/weed (june, orchard, sweet timothy, cocklebur and ragweed), tree (ash, black birch, elm, maple, oak, pine, poplar and willow) and fungal allergens (Alternaria alternata, Aspergillus flavus, Cephalosporium, Cephalothecium, Fusarium, Helminthosporium, Hormodendrum, Monilia sitophila, Mucor, Penicillium, Phoma, and Rhizopus) from ALK (Hørsholm, Denmark).
SPTs were performed by placing a drop of test solution on the skin and pricking the epidermis beneath the drop with a disposable plastic lancet (J.N. Eberle GmbH Hochfeldrasse 6–8 D-86830 Schwabmuenchen, Germany). SPT sites were wiped clean and after fifteen minutes, the wheal and flare reactions were outlined and the diameters measured. Histamine (10 mg/mL) was used as a positive control and diluent (HSA in 50% glycerol) was used as a negative control. A positive reaction was characterized as 3 mm or greater than that of the negative control.
Serological quantification of sIgE and sIgG titers was conducted by fluoroenzyme immunoassay using a Phadia ImmunoCAP 100 (Phadia AB, Uppsala, Sweden).
sIgE was quantified to selected environmental allergens using a sIgE multiple allergen stir to grass (gx1), molds (mx2), and trees (tx1). The grass stir (gx1) was comprised of Dactylis glomerata (g3), Festuca elatior (g4), Lolium perenne (g5), Phleum pratense (g6), and Poa pratense (g8). The mold stir (mx2) was comprised of Penicillium chrysogenum (m1), Cladosporium herbarum (m2), Aspergillus fumigatus (m3), Candida albicans (m5), A. alternata (m6), and Setomelanomma rostrata (m8).
The tree pollen stir (tx1) was comprised of Acer negundo (t1), Betula verrucosa (t3), Quercus alba (t7), Ulmus americana (t8), and Juglans californica (t10). sIgE was considered detectable when 65 allergen specific units (kUA/L) were exceeded. sIgG titers were also measured using ImmunoCAP for a 4-mold panel: C. herbarum (Gm2), A. alternata (Gm6), Stachybotrys atra (RGm24), and Aspergillus versicolor (RGm25). sIgG <0.02 mg/L was considered undetectable as previously described.
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One hundred and fifty eight study participants from the Toronto metropolitan area (19–70 years of age) were recruited into the study.
One hundred and one subjects were diagnosed with a history of CRS and 57 subjects were recruited as controls with chronic spontaneous urticaria (CIU). These study participant numbers were not based on a sample size calculation.
CRS was physician diagnosed by physical exam based on the following symptomology: sinus congestion or fullness; facial pain, pressure or fullness; nasal obstruction or blockage; purulent anterior or posterior nasal drainage; and decrease sense of smell. Every CRS patients had endoscopy and CT scans confirming diagnosis of CRS.
CIU is generally considered a non-IgE mediated disease and physician diagnosed patients were recruited to the control population as a way to control for confounding variables. When possible, consecutive patients presenting to the clinic were recruited to this study.
Enrolled subjects underwent skin prick testing (SPT) and were asked to provide a blood sample by venipuncture (20 mL) for serological analysis of specific immunoglobulin E (sIgE) and G (sIgG). Human serum was separated in vitro from the collected blood samples and then transferred to the National Institute for Occupational Safety and Health (NIOSH) and stored at −80°C until serological analysis.
This study was approved by the NIOSH Human Subject Review Board (05-HELD-04XP) and the Ontario Institutional Review Board Services.
Informed consent was obtained from every participants.
The data analysis for this manuscript was generated using SAS/STAT software, Version 9.1 of the SAS System for Windows (SAS Institute Inc., Cary, NC, USA). Chi-square analysis was performed using Fishers Exact option to determine if the proportion of positive SPT’s were diverse between groups. Antibody levels were compared using Analysis of Variance. Every differences were considered significant at p < 0.05.