292:), and Pharmacia CAP. A review of applicable quality assessment programs shows that this new test has replaced the original RAST in approximately 80% of the world's commercial clinical laboratories, where specific IgE testing is performed. The newest version, the ImmunoCAP Specific IgE 0–100, is the only specific IgE assay to receive FDA approval to quantitatively report to its detection limit of 0.1kU/L. This clearance is based on the CLSI/NCCLS-17A Limits of Detection and Limits of Quantitation, October 2004 guideline.The guidelines for diagnosis and management of food allergy issues by the National Institute of Health state that:
102:
Drawbacks to RAST and ImmunoCAP techniques do exist. Compared to skin testing, ImmunoCAP and other RAST techniques take longer to perform and are less cost effective. Several studies have also found these tests to be less sensitive than skin testing for the detection of clinically relevant allergies.
153:
The suspected allergen is bound to an insoluble material and the patient's serum is added. If the serum contains antibodies to the allergen, those antibodies will bind to the allergen. Radiolabeled anti-human IgE antibody is added where it binds to those IgE antibodies already bound to the insoluble
90:
Advantages of the allergy blood test range from: excellent reproducibility across the full measuring range of the calibration curve, it has very high specificity as it binds to allergen specific IgE, and extremely sensitive too, when compared with skin prick testing. In general, this method of blood
562:
Cox, L.; Williams, B.; Sicherer, S.; Oppenheimer, J.; Sher, L.; Hamilton, R.; Golden, D. (2008). "Pearls and pitfalls of allergy diagnostic testing: Report from the
American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force".
98:
Adults and children of any age can take an allergy blood test. For babies and very young children, a single needle stick for allergy blood testing is often more gentle than several skin tests. However, skin testing techniques have improved. Most skin testing does not involve needles and typically
86:
The two most commonly used methods of confirming allergen sensitization are skin testing and allergy blood testing. Both methods are recommended by the NIH guidelines and have similar diagnostic value in terms of sensitivity and specificity.
288:, Uppsala, Sweden, and the acronym RAST is actually a brand name. In 1989, Pharmacia Diagnostics AB replaced it with a superior test named the ImmunoCAP Specific IgE blood test, which literature may also describe as: CAP RAST, CAP FEIA (
91:
testing (in-vitro, out of body) vs skin-prick testing (in-vivo, in body) has a major advantage: it is not always necessary to remove the patient from an antihistamine medication regimen, and if the skin conditions (such as
95:) are so widespread that allergy skin testing cannot be done. Allergy blood tests, such as ImmunoCAP, are performed without procedure variations, and the results are of excellent standardization.
713:
299:
recommended that the RAST measurements of specific immunoglobulin E for the diagnosis of allergy be abandoned in favor of testing with more sensitive fluorescence enzyme-labeled assays.
296:
528:
510:
150:, the test may indicate the person is allergic to pollen (or pollen-like) proteins. A person who has outgrown an allergy may still have a positive IgE years after exposure.
548:
332:
NIH Guidelines for the
Diagnosis and Management of Food Allergy in the United States. Report of the NIAID- Sponsored Expert Panel, 2010, NIH Publication no. 11-7700.
706:
175:
a patient has such a high sensitivity level to suspected allergens that any administration of those allergens might result in potentially serious side effects.
350:
Hamilton R et al. Proficiency Survey-Based
Evaluation of Clinical Total and Allergen-Specific IgE Assay Performance. Arch Pathol Lab Med. 2010; 134: 975–982
699:
118:
With over 4000 scientific articles using ImmunoCAP and showing its clinical value, ImmunoCAP is perceived as "Gold standard" for in vitro IgE testing
108:
807:
154:
material. The unbound anti-human IgE antibodies are washed away. The amount of radioactivity is proportional to the serum IgE for the allergen.
372:
Chinoy B, Yee E, Bahna SL. Skin testing versus radioallergosorbent testing for indoor allergens. Clin Mol
Allergy. 2005 Apr 15;3(1):4.
757:
612:"Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel"
730:
116:"The predictive values associated with clinical evidence of allergy for ImmunoCAP cannot be applied to other test methods."
747:
792:
772:
475:
Wang J, Godbold JH, Sampson HA (2008). "Correlation of serum allergy (IgE) tests performed by different assay systems".
902:
514:
955:
341:
Cox, L. Overview of
Serological-Specific IgE Antibody Testing in Children. Pediatric Allergy and Immunology. 2011.
924:
360:
308:
887:
685:
27:
161:
a physician advises against the discontinuation of medications that can interfere with test results or cause
837:
289:
162:
143:
762:
430:
Boyce J et al. Guidelines for the
Diagnosis and Management of Food Allergy in the United States: Report of
877:
767:
127:
63:
46:
611:
597:
384:"Inhibition of IgE binding to cross-reactive carbohydrate determinants enhances diagnostic selectivity"
950:
897:
691:
675:
681:
892:
861:
739:
827:
822:
669:
914:
641:
580:
542:
492:
457:
413:
313:
75:
845:
817:
631:
623:
572:
484:
449:
403:
395:
131:
104:
67:
909:
752:
523:
636:
408:
383:
78:, which determines allergy by the reaction of a person's skin to different substances.
576:
453:
944:
849:
882:
722:
33:
854:
784:
488:
627:
919:
726:
361:
http://www.uptodate.com/contents/overview-of-skin-testing-for-allergic-disease
285:
645:
584:
496:
461:
440:
Wood R; et al. (2007). "Accuracy of IgE antibody laboratory results".
417:
284:
The market-leading RAST methodology was invented and marketed in 1974 by
146:: for example, if a person exhibits a high level of IgE directed against
139:
135:
802:
71:
399:
114:
In the NIH food guidelines issued in
December 2010 it was stated that
929:
169:
147:
92:
797:
598:
WebMD > Medical
Dictionary > radioallergosorbent test (RAST)
41:
600:
Citing: Stedman's
Medical Dictionary 28th Edition. Copyright 2006
138:
for the purpose of guiding a diagnosis about allergy. IgE is the
695:
70:
antibodies in order to determine the substances a subject is
168:
a patient has severe skin conditions such as widespread
515:"Five Things Physicians and Patients Should Question"
297:
National
Institute of Allergy and Infectious Diseases
99:
skin testing results in minimal patient discomfort.
870:
836:
783:
738:
672:- Americal Academy of Allergy Asthma and Immunology
529:
American Academy of Allergy, Asthma, and Immunology
511:
American Academy of Allergy, Asthma, and Immunology
186:
40:
26:
21:
157:RASTs are often used to test for allergies when:
103:False positive results may be obtained due to
616:The Journal of Allergy and Clinical Immunology
610:NIAID-Sponsored Expert Panel (December 2010).
273:Extremely high level of allergen specific IgE
707:
207:Absent or undetectable allergen specific IgE
8:
547:: CS1 maint: multiple names: authors list (
184:The RAST is scored on a scale from 0 to 6:
714:
700:
692:
565:Annals of Allergy, Asthma & Immunology
262:Ultra high level of allergen specific IgE
684:at the U.S. National Library of Medicine
635:
407:
251:Very high level of allergen specific IgE
229:Moderate level of allergen specific IgE
109:cross-reactive carbohydrate determinants
808:Enzyme multiplied immunoassay technique
325:
540:
522:Choosing Wisely: an initiative of the
18:
7:
240:High level of allergen specific IgE
218:Low level of allergen specific IgE
758:Ouchterlony double immunodiffusion
14:
134:antibodies to suspected or known
1:
748:Chromatin immunoprecipitation
577:10.1016/S1081-1206(10)60220-7
454:10.1016/s1081-1206(10)60618-7
107:of homologous proteins or by
74:to. This is different from a
793:Chemiluminescent immunoassay
773:Counterimmunoelectrophoresis
903:Direct fluorescent antibody
489:10.1016/j.jaci.2007.12.1150
972:
628:10.1016/j.jaci.2010.10.007
442:Ann Allergy Asthma Immunol
295:In 2010 the United States
259:50.00 ≤ level < 100.00
925:Total complement activity
248:17.50 ≤ level < 50.00
888:Complement fixation test
686:Medical Subject Headings
682:Radioallergosorbent+Test
477:J. Allergy Clin. Immunol
286:Pharmacia Diagnostics AB
237:3.50 ≤ level < 17.50
144:Type I allergic response
62:) is a blood test using
56:radioallergosorbent test
22:Radioallergosorbent test
16:Allergy test using blood
226:0.70 ≤ level < 3.50
215:0.35 ≤ level < 0.70
763:Radial immunodiffusion
382:Holzweber, F. (2013).
309:Prausnitz-Küstner test
290:fluorenzymeimmunoassay
878:Diagnostic immunology
768:Immunoelectrophoresis
676:Allergy Blood Testing
163:medical complications
128:radioimmunoassay test
64:radioimmunoassay test
898:Immunohistochemistry
893:Immunocytochemistry
862:Latex fixation test
740:Immunoprecipitation
130:to detect specific
66:to detect specific
828:Immunofluorescence
823:Radiobinding assay
678:- Lab Tests Online
956:Immunologic tests
938:
937:
915:Skin allergy test
400:10.1111/all.12229
394:(10): 1269–1277.
314:Skin allergy test
277:
276:
193:IgE Level (kU/L)
76:skin allergy test
52:
51:
963:
846:Hemagglutination
818:Radioimmunoassay
716:
709:
702:
693:
657:
656:
654:
652:
639:
607:
601:
595:
589:
588:
559:
553:
552:
546:
538:
537:
535:
519:
507:
501:
500:
472:
466:
465:
437:
431:
428:
422:
421:
411:
379:
373:
370:
364:
357:
351:
348:
342:
339:
333:
330:
204:level < 0.35
187:
142:associated with
105:cross-reactivity
36:
19:
971:
970:
966:
965:
964:
962:
961:
960:
941:
940:
939:
934:
910:Epitope mapping
866:
832:
779:
753:Immunodiffusion
734:
720:
666:
661:
660:
650:
648:
609:
608:
604:
596:
592:
561:
560:
556:
539:
533:
531:
524:ABIM Foundation
517:
509:
508:
504:
474:
473:
469:
439:
438:
434:
429:
425:
381:
380:
376:
371:
367:
358:
354:
349:
345:
340:
336:
331:
327:
322:
305:
282:
270:level ≥ 100.00
182:
124:
84:
32:
17:
12:
11:
5:
969:
967:
959:
958:
953:
943:
942:
936:
935:
933:
932:
927:
922:
917:
912:
907:
906:
905:
895:
890:
885:
880:
874:
872:
868:
867:
865:
864:
859:
858:
857:
842:
840:
834:
833:
831:
830:
825:
820:
815:
810:
805:
800:
795:
789:
787:
781:
780:
778:
777:
776:
775:
770:
765:
760:
750:
744:
742:
736:
735:
721:
719:
718:
711:
704:
696:
690:
689:
679:
673:
665:
664:External links
662:
659:
658:
602:
590:
571:(6): 580–592.
554:
502:
483:(5): 1219–24.
467:
432:
423:
374:
365:
352:
343:
334:
324:
323:
321:
318:
317:
316:
311:
304:
301:
281:
278:
275:
274:
271:
268:
264:
263:
260:
257:
253:
252:
249:
246:
242:
241:
238:
235:
231:
230:
227:
224:
220:
219:
216:
213:
209:
208:
205:
202:
198:
197:
194:
191:
181:
178:
177:
176:
173:
166:
126:The RAST is a
123:
120:
83:
80:
50:
49:
44:
38:
37:
30:
24:
23:
15:
13:
10:
9:
6:
4:
3:
2:
968:
957:
954:
952:
949:
948:
946:
931:
928:
926:
923:
921:
918:
916:
913:
911:
908:
904:
901:
900:
899:
896:
894:
891:
889:
886:
884:
881:
879:
876:
875:
873:
869:
863:
860:
856:
853:
852:
851:
850:Hemagglutinin
847:
844:
843:
841:
839:
838:Agglutination
835:
829:
826:
824:
821:
819:
816:
814:
811:
809:
806:
804:
801:
799:
796:
794:
791:
790:
788:
786:
782:
774:
771:
769:
766:
764:
761:
759:
756:
755:
754:
751:
749:
746:
745:
743:
741:
737:
732:
728:
724:
723:Medical tests
717:
712:
710:
705:
703:
698:
697:
694:
687:
683:
680:
677:
674:
671:
668:
667:
663:
647:
643:
638:
633:
629:
625:
622:(6): S1–S58.
621:
617:
613:
606:
603:
599:
594:
591:
586:
582:
578:
574:
570:
566:
558:
555:
550:
544:
530:
526:
525:
516:
512:
506:
503:
498:
494:
490:
486:
482:
478:
471:
468:
463:
459:
455:
451:
447:
443:
436:
433:
427:
424:
419:
415:
410:
405:
401:
397:
393:
389:
385:
378:
375:
369:
366:
362:
356:
353:
347:
344:
338:
335:
329:
326:
319:
315:
312:
310:
307:
306:
302:
300:
298:
293:
291:
287:
279:
272:
269:
266:
265:
261:
258:
255:
254:
250:
247:
244:
243:
239:
236:
233:
232:
228:
225:
222:
221:
217:
214:
211:
210:
206:
203:
200:
199:
195:
192:
189:
188:
185:
179:
174:
171:
167:
164:
160:
159:
158:
155:
151:
149:
145:
141:
137:
133:
129:
121:
119:
117:
112:
110:
106:
100:
96:
94:
88:
81:
79:
77:
73:
69:
65:
61:
57:
48:
45:
43:
39:
35:
31:
29:
25:
20:
883:Nephelometry
812:
733:86000–86849)
649:. Retrieved
619:
615:
605:
593:
568:
564:
557:
532:, retrieved
521:
505:
480:
476:
470:
448:(1): 34–41.
445:
441:
435:
426:
391:
387:
377:
368:
355:
346:
337:
328:
294:
283:
190:RAST Rating
183:
156:
152:
125:
115:
113:
101:
97:
89:
85:
82:Medical uses
59:
55:
53:
951:Blood tests
855:Coombs test
785:Immunoassay
945:Categories
920:Patch test
727:immunology
534:August 14,
359:UpToDate (
320:References
813:RAST test
670:Allergies
651:30 August
136:allergens
725:used in
646:21134576
585:19119701
543:citation
497:18243289
462:17650827
418:24107260
303:See also
196:Comment
140:antibody
111:(CCDs).
72:allergic
803:ELISpot
637:4241964
409:4223978
388:Allergy
280:History
47:13834-7
34:D011852
930:MELISA
688:(MeSH)
644:
634:
583:
495:
460:
416:
406:
170:eczema
148:pollen
122:Method
93:eczema
871:Other
798:ELISA
518:(PDF)
180:Scale
42:LOINC
653:2012
642:PMID
581:PMID
549:link
536:2012
493:PMID
458:PMID
414:PMID
60:RAST
28:MeSH
731:CPT
632:PMC
624:doi
620:126
573:doi
569:101
485:doi
481:121
450:doi
404:PMC
396:doi
132:IgE
68:IgE
947::
640:.
630:.
618:.
614:.
579:.
567:.
545:}}
541:{{
527:,
520:,
513:,
491:.
479:.
456:.
446:99
444:.
412:.
402:.
392:68
390:.
386:.
267:6
256:5
245:4
234:3
223:2
212:1
201:0
172:or
54:A
848:/
729:(
715:e
708:t
701:v
655:.
626::
587:.
575::
551:)
499:.
487::
464:.
452::
420:.
398::
363:)
165:;
58:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.