By Mark H. Moss MD, Randy J. Horwitz MD, PhD, Robert F. Lemanske Jr. MD (auth.), Phil Lieberman MD, John A. Anderson MD (eds.)
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Extra info for Allergic Diseases: Diagnosis and Treatment
IgE in the serum becomes bound to the solid-phase anti-IgE in proportion to the concentration of IgE in the serum sample. After unbound proteins are washed away, the quantity of lgE bound to the solid phase is determined by reacting the solid phase with the second, soluble, labeled anti-IgE antibody. Mter another wash to remove the unbound, labeled anti-IgE, the quantity of labeled IgE on the solid phase is measured and converted into units of IgE by comparison to a standard curve. A variety of commercial assays is available.
Nelson HS, Rosloniec DM, McCAll Ll, Ikle D. Comparative performance of five commercial prick skin test devices. J Allergy Clin Immuno/1993;92:750-756. Reid MJ, Lockey RF, Turkeltaub, PC, et al. Survey of fatalities from skin testing and immunotherapy 1985-1989. J Allergy Clin Immunol1993;19:6-15. Schwartz J, Weiss ST. Relationship of skin test reactivity to decrements in pulmonary function in children with asthma or frequent wheezing. Am J Respir Crit Care Med 1995;152:2176-2180. Sampson HA, Ho DG.
PHYSICAL EXAMINATION An allergic patient's history may direct the clinician's examination to a particular area or organ system. A specific allergic symptom, however, should not divert the examiner's attention from the patient as a whole. Each patient should be approached in a systematic way. Often, physical examination may not be unusual; lack of findings do not rule out allergy. Vital signs are a starting point in any examination. Pulse rate and pulsus paradoxicus >10 mmHg are two of the most sensitive indicators of severe airways obstruction.