SCREENING FOR IGE-MEDIATED ALLERGY

Atopic allergy affects approximately one-third of people under 30 year s of age who live in industrialized countries. It is also a problem in nonindustrialized countries, but its extent is less well documented. The most common diseases associated with atopy are asthma, rhinitis, a nd eczema, but other skin and even gastrointestinal complaints may als o be atopic in nature. However, it has to be recognized that these dis eases have nonatopic counterparts (i.e., IgE antibodies do not partici pate in their pathogenesis). It is rare for allergic attack to prove f atal, but drugs, venoms, or foods can provoke anaphylactic reactions. However, allergy is usually incapacitating and results in considerable inconvenience due to lost time at work, school, and play. In the USA, 35 million people (17% of the population) are affected at a cost per annum of $1.5 billion, and as a result 5 million working days are lost each year (1). Similar figures for probable direct and indirect costs are available from Europe and Japan. Moreover, recent surveys from al l over the world conclude that more people are dying from asthma than 20 years ago. The remedy for this situation is not readily at hand, be cause the number of allergies requiring diagnosis and attention is muc h larger than the number of clinicians adequately trained in the subje ct. Consequently, the introduction of procedures that can be used by o ther clinicians as well as by allergists should help to reduce the bur den of recognizing and diagnosing allergy. This is a worthwhile object ive. We discuss the importance of three screening procedures: clinical history taken by questionnaire and analyzed with computer assistance, serum total IgE, and the multiallergen screening tests for commonly i nhaled allergens. A combination of all three tests is more powerful th an any individual one, because each has its limitations.