Could I be allergic?
An allergy is an exaggerated response by the immune system to a substance foreign to the body (allergen).
About thirty percent of Portuguese people have allergies. People with allergies, or “atopic patients,” are characterized by increased production of a type of protein called immunoglobulin E (IgE), which reacts specifically to allergens.
These IgE proteins coat cells (mast cells and basophils) that are rich in substances which cause the unpleasant allergic symptoms and are released when allergens come into contact with those proteins. Allergy sufferers sometimes associate their symptoms with the allergen that triggers them. Often this is not the case, and only a doctor—specifically an immunologist-allergist—can make an accurate diagnosis of the condition. To do so, the doctor relies on the patient’s medical history and symptoms, a physical examination, and laboratory tests.
With regard to symptoms, patients fall into four main groups: In one group, rhinitis predominates, manifesting as nasal congestion, rhinorrhea (“runny nose”), sneezing, and nasal and ocular pruritus (itching); in another group, eczema is the most common complaint, manifesting as constant itching and redness, followed by dryness and flaking of the affected skin area; in yet another group, asthma is the main symptom, manifesting as wheezing, coughing, and dyspnea (difficulty breathing, of varying severity), is the main symptom; in a final group, food allergies predominate, with a range of symptoms ranging from hives to diarrhea, eczema, or asthma.
Once the clinical diagnosis has been made, it is essential to identify the specific allergen(s) involved: dust mites, house dust, cat and dog dander, mold, cockroaches, grass pollen, tree and weed pollen, milk, eggs, peanuts, fish, shellfish, nuts, and many others. To do this, the doctor uses prick tests to check the patient’s skin reaction to suspected allergens and almost always requests confirmation from a clinical pathologist, who measures and identifies the specific IgE antibodies for the allergens in question using special tests (RASTs).
In the treatment of acute episodes, antihistamines, corticosteroids, or aminophylline are administered intravenously or intramuscularly, or beta-adrenergic agents are administered via nebulization. In the chronic phase, in addition to medication that relieves symptoms, the patient must be kept away from the triggering allergen and undergo desensitization, allowing the immune system to gradually become accustomed to the agent causing the allergy.
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CLINICAL PATHOLOGY LABORATORY
