Can we rely on what we think we’re allergic to?

Published online: January 14, 2019

A mainstay of allergy management is allergen avoidance, which depends upon appropriate recognition of responsible allergens. Because obtaining history from patients is the initial step in allergy care, knowledge of the degree of agreement between patients’ perceived allergen sensitization versus actual allergen sensitization is vital background.

A research article recently published in The Journal of Allergy and Clinical Immunology: In Practice by Pham et al. examined the agreement between perceived and actual sensitization to 10 common indoor and outdoor aeroallergens in an urban pediatric population. Detailed questionnaires regarding perceived sensitization and serum specific IgE measurements to common aeroallergens were completed by 253 children.

The authors found that agreement between perceived and actual sensitization was fair for most aeroallergens, with greatest agreement for cat dander and dust. Those who perceived a cat allergy had a nearly 6-times greater odds of sensitization to cat dander. There was over 2-fold odds of sensitization to dust, dog dander, or grass pollen given perceived sensitization to their respective allergens. Additionally, among children who perceived having no allergy, 5.4% to 30.4% had positive serum allergy test results. In this group of patients, indoor allergen sensitization was more common.

Children who perceive allergen sensitization to cat, dog, dust or grass are likely to demonstrate actual sensitization to these individual allergens. Children with no perceived sensitization to allergens are nonetheless frequently sensitized. These findings highlight the importance of using both patient history and guided diagnostic tests in the care of patients with allergic diseases.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.