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Rationale for Specific Allergen Testing of Patients With Asthma in the Clinical Pulmonary Office SettingOffice Allergen Testing

Edward S. Schulman, MD, FCCP; Carol Pohlig, RN, CPC, ACS
Author and Funding Information

From the Division of Pulmonary, Critical Care and Sleep Medicine (Dr Schulman), Department of Medicine, Drexel University College of Medicine; and Department of Medicine (Ms Pohlig), University of Pennsylvania Health System, Philadelphia, PA.

CORRESPONDENCE TO: Edward S. Schulman, MD, FCCP, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Drexel University College of Medicine, Mail Stop 107, 245 N 15th St, Philadelphia, PA 19102; e-mail: edward.schulman@drexelmed.edu


FUNDING/SUPPORT: Support for third-party writing assistance for this article was provided by Genentech, Inc, and Novartis Pharmaceuticals.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):251-258. doi:10.1378/chest.12-0072
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Asthma is a chronic inflammatory disease that affects an estimated 25 million people in the United States. In 70% to 90% of cases, asthma is associated with IgE-mediated mechanisms, which have proved central to allergen-induced inflammation in preclinical and clinical models. The importance of IgE levels in patients with moderate to severe asthma has been confirmed in randomized controlled studies with a targeted IgE blocker. Advances in laboratory methods to detect and quantify allergen-specific IgE antibodies have allowed for a quick-and-easy diagnosis of allergic IgE-mediated sensitivities in the office. Pulmonologists tend to order in vitro tests to measure allergen-specific IgE rather than to perform allergen skin testing, which is seen as the purview of allergists. This article reviews the importance of allergen testing in patients with asthma—whether by skin testing or by in vitro methods—and highlights the advantages, limitations, and interpretation of results derived from each method. Additionally, this article includes suggested documentation and administrative details for physician reporting in the office setting.

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