Practically anybody suffering from troublesome allergy symptoms for longer period of time should go for allergy testing.
2. I have cold twice a year, Shall I go for Skin Prick Allergy Testing?
Now, if someone has occasional cold few times a year and controlled easily by routine medicine he/she should not go for testing, but (a) Symptoms are very frequent (b) Symptoms are severe compelling to take frequent medicine (c) Symptoms are disturbing day to day routine e.g., study in case of students or day to day work in case of adults (d) Symptoms are increasing in severity over a period of time (e) When other parts are involved e.g. If patient has mild allergic rhinitis which increases in severity and allergic pharyngitis, allergic bronchitis, or allergic asthma starts developing (f) Even single episode as in case of honey bee where anaphylaxis(severe reaction) has occurred
(g) Where symptoms are chronic & long standing because long standing anti allergic drugs have side effects. (h) One has to take steroids frequently (I) Recurrence of nasal symptoms or polyps after surgery
In all above cases Skin Prick Testing and Immunotheraphy is Advised.
3. Why Skin Prick Testing and not blood testing to find out allergen?
(1) First & foremost is reliability, practically all standard textbooks of Allergy say that confirm report of positive allergens (blood tests) by skin prick test before going for further treatment. Then why not to go directly for Skin Prick Testing? (2) Collection of blood sample, proper labeling, proper transport (maintaining cold chain),latest well serviced equipment, well trained staff ....play a major role in reliability of report, human error and machine error play significant role. (3) Skin Prick Allergy Testing is done by Allergy Specialist himself
in front of patient and relative with the same allergens which
show positivity in other patients on day to day basis. (4) Allergens available for blood testing are not those prevalent in
local area as many kits are imported e.g. certain pollens
prevalent in our country are not present in the testing kit
and many are present which are not even in our country so it
is meaningless exercise in many cases. (5) Many blood testing advocates frighten patients of reaction in
skin prick testing, but now a days with good allergen extracts and prick method instead of intradermal injection method it has become rare. (6) When patient himself/herself sees swelling and redness over skin it convinces him/her along with treating Allergologist regarding positive allergens, so he/she becomes ready for immunotherapy. (7) Skin Prick Testing is a very gentle superficial prick where even blood don't comes out so it is not painful. Even children easily allow to perform testing. (8) Reports are faster i.e. with in few hours. Blood report may take many days or weeks if carried out in distant big laboratories..usual scenario (9) Skin Prick Testing is cheaper (10) Lastly in blood testing different groups are made of allergens and they are tested together so sometimes positivity to single allergen is not known.
4. What are the groups of allergens?
Mainly two Inhalants and food which are tested routinely and in majority of cases inhalant allergens are responsible for respiratory allergies e.g. allergic rhinitis, bronchitis, asthma, while food allergens are responsible for skin allergies e.g. urticaria, dermatitis There is a third group known as contactants responsible for contact dermatitis e.g. chemicals & dyes.
5. What is Allergen Specific Immunotherapy?
Here gradually increasing doses of allergen is given to the patient over a period of time to which he/she has been found to be significantly allergic in Skin Prick Testing. Here immunity / resistance of patient increases & further exposure gives no symptoms or les symptoms.
6. What is duration of Immunotherapy?
It depends upon severity of initial disease and response to the Therapy But it is of long duration. For example 2-3 years in allergic rhinitis and 4-5 years in allergic bronchial asthma..Individual patient has to be assessed regarding duration by allergy specialist.
7. Is Immunotherapy very painful?
NOT AT ALL. It is given subcutaneously like insulin injection in diabetics. Now a days oral (sublingual) drops are available with equal potency where one has to put drops underneath the tongue at home only.
8 Is Immunotherapy safe?
Occasional cases of local or systemic reaction were noted with subcutaneous - injectable immunotherapy. But advent of Sublingual Immunotherapy has made it very safe.
9. Are there any side effects of Immunotherapy?
As the same allergen which was found positive in Skin Prick Allergy Test is given in SLIT(Sublingual Immunotherapy),It has no side effects Practically. If patient has occasionally more symptoms then dosage adjustment is required.
10. If my disease is well controlled with medicine, why shall I go for
Immunotherapy?
Very intelligent question. Medicine which you are taking now is in no way modifying or curing your disease. It is simple symptomatic treatment. So over a period of time disease may increase in severity and the medicine you are taking has definite side-effects. You might have to increase dosage of medicine. Simple example is 30-40% of cases of allergic rhinitis sooner or later develop allergic bronchial asthma.
11. Is Immunotherapy safe during pregnancy?
It is protocol nowadays that if immunotherapy is going on and patient becomes pregnant, it should be continued, but in pregnant patient
immunotherapy shouldn't be started afresh.
12. What is the success rate of Immunotherapy?
It depends upon so many factors, but grossly almost 80% of cases ofallergic rhinitis and insect(honey bee) allergy patients do reallywell,40-50% of patients of allergic bronchitis & asthma show significant
improvement.
13. What is the role of alternative medicine?
Being the allopathic Doctor, I am not the right person to answer this, but in modern era if you believe in evidence based medicine, you should go for Skin Prick Allergy Testing and Immunotherapy before trying anything
else.
14. Is Skin Prick Testing and Immunotherapy very expensive?
NOT AT ALL. If you consider lifelong medicine probably you would be taking to control the symptoms and always fearing increasing severity of
symptoms, this treatment is cheap.
15. I have dust allergy. What should I do?
Dust Allergy is very loose term. It could be House Dust Mite. In majority of cases, house dust containing so many particles or various dusts like cotton dust, silk dust, saw dust, polish dust, hay dust, grain dust, spider web dust or fungi admixed with dust could be the cause. So one should go for Skin Prick Testing to pin point the Allergen.
16. Is Allergy hereditary?
Usually allergy has some family history in blood relation e.g.in form of Allergic rhinitis, bronchitis, asthma, skin allergy or drug
reaction, it is not must.
17. Will I die if I not got treated my Allergy?
No except severe allergic drug reaction or rarely anaphylaxis following Honey Bee sting or occasionally severe food allergy leading to angioedema. Allergy is not a disease to be ignored.
18. What is the guarantee that I will be cured of my allergy if I undergo
skin testing and Immunotherapy?
Allergy is a very complex disease, and never go to anybody who guarantees cure in any disease as it is not guaranted by God that one would reach alive at his home after leaving his office--But there are a lot of scientific data to suggest that there are ample chances of your getting significantly relieved of your symptoms.
Majority of patients do really well.
19. Which is better avoiding Allergen or Immunotherapy?
Of course Avoidance of allergen is first line of treatment, suppose you have dog allergy and you remove that from your surrounding you will be cured, but in majority of cases it is imposible to avoid allergen e.g. house dust mite where vaccine (Immunotherapy) is must as a treatment along with avoidance
measures.
20. Which is the most common allergen?
House Dust Mite is the commonest allergen globally. Large number of patients show positivity on Skin Prick Test, and Immunotherapy has very good
result also.
