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Published in: Clinical and Translational Allergy 1/2014

Open Access 01-12-2014 | Research

Diagnosis and allergen immunotherapy treatment of polysensitised patients with respiratory allergy in Spain: an Allergists’ Consensus

Authors: Carmen Vidal, Ernesto Enrique, Angeles Gonzalo, Carmen Moreno, Ana I Tabar

Published in: Clinical and Translational Allergy | Issue 1/2014

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Abstract

Background

Polysensitisation is common in patients with respiratory allergy in Spain. Selection of the best allergen immunotherapy (AIT) is difficult in polysensitised patients. The present study was designed to help allergists better identify relevant allergens in these patients and to improve the selection of AIT in Spain.

Methods

Sixty-two Spanish allergists answered a survey containing 88 items divided into four groups: 1) general approach to polysensitised subjects; 2) sensitisation profile involving mite, animal dander and moulds; 3) grass and olive pollen co-sensitisation, and 4) other pollen polysensitisation profile (weed and tree pollen). The Delphi method was used.

Results

A consensus was achieved for 83% of items (92%, 81%, 83% and 73% of the four groups analysed, respectively). Only polysensitised patients with clinical relevance should be considered polyallergic. A detailed medical history (clinical symptoms and medication) together with a profound knowledge of allergens present in the patient’s environment are essential for diagnosis. Skin prick tests (SPTs) are not adequate to decide the clinical relevance of each allergen. Serum specific IgE against allergen sources adds value to SPT but molecular diagnosis, when possible, is strongly recommended, especially in pollen-allergic patients. Specific allergen challenge tests are difficult to perform and not recommended for daily practice. Regarding AIT composition, up to three allergens can be used in the same vaccine, but only related allergens may be mixed. In some cases more than one vaccine may be needed.

Conclusion

Some criteria have been established to improve diagnosis and AIT prescription in polysensitised patients.
Appendix
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Metadata
Title
Diagnosis and allergen immunotherapy treatment of polysensitised patients with respiratory allergy in Spain: an Allergists’ Consensus
Authors
Carmen Vidal
Ernesto Enrique
Angeles Gonzalo
Carmen Moreno
Ana I Tabar
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2014
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/2045-7022-4-36

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