Indications du dosage des IgE spécifiques dans le diagnostic et le suivi des maladies allergiques - IgE abstract

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Posted on May 01 2005 A summary statement in English will be available in due course. Posted on May 01 2005

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Indications for the specific-IgE test for the diagnosis monitoring of allergies Haute Autorité de santé (French National Authority for Health), Saint-Denis La Plaine, France Authors: Emmanuel Corbillon, MD, Jean-Marc Rame, MD

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Aim To establish the indications for the specific-IgE test for the diagnosis and monitoring of allergies.

Results and conclusions (i)Critical literature review.The review covered allergic reactions in relation to: -specific body systems: respiratory system, allergic conjunctivitis; -specific allergens: foods, latex, insect stings, hymenoptera venom, drugs; -specific situations: perioperative context, work-related allergies. Most clinical guidelines and reviews were based on studies of poor design quality and with little relevance to clinical practice. Studies on the IgE test were of a low level of evidence. (ii)for diagnosis and monitoring of existing allergies.Indications for the IgE test The report's conclusions were based on strong agreement among the working group members. The working group issued the following reminders: -As for skin testing, the presence of specific IgEs indicates the body's sensitivity to the test substance and does not necessarily imply an allergy to the substance. The sensitivity can result from direct contact with the allergen or from a cross-reaction with a homologous substance. -When a specific-IgE test is ordered, the allergen should be specified and should not refer to a brand name. Methods The report was produced using a recognised technology assessment method combining a critical literature review with experts’ opinions. Several databases (Medline, Embase and Pascal) were searched for the period 1988-May 2004, together with useful websites and the grey literature. A draft report was produced and submitted to a working group of 12 members nominated by relevant learned societies. The report was amended and then submitted to a multidisciplinary group of 13 peer reviewers for comment.

Looking ahead The working group stressed the need for: - continued research, - training of physicians in basic and practical aspects of allergology, during both initial and continuing medical education, - rewriting of the section of the French Nomenclature for Biomedical Tests (NABM)relating to allergy, to make it more precise, complete and applicable, - complete information for professionals (prescribers and laboratory analysts) on the rules for prescribing allergy tests and obtaining reimbursement. - information for patients on the nature and significance of the tests prescribed for them. HAS. 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France tel: +33 1 55 93 70 00, fax: +33 1 55 93 74 00, www.has-sante.fr

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