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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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In vivo and in vitro allergy diagnostics: it's time to reappraise the costs

Franco Borghesan1 / Daniela Bernardi2 / Mario Plebani3

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Corresponding author: Mario Plebani, Department of Laboratory Medicine, University-Hospital of Padova, Via Giustiniani, 2, 35128 Padova, Italy Phone: +39-049-8212792, Fax: +39-049 663240

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 3, Pages 391–395, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2007.077, March 2007

Publication History

Received:
October 3, 2006
Accepted:
December 20, 2006

Abstract

Background: The in vivo skin prick test (SPT) is widely considered less expensive than in vitro γ-immunoglobulin E (IgE) determination in the diagnosis of allergy. The aim of the present paper is to evaluate the relevance of component-resolved in vitro diagnosis in comparison to extract-based diagnosis and the relative global costs in relation to clinical outcomes.

Methods: For 50 individuals with suspected seasonal allergic rhinitis, we compared the costs of skin testing with those of specific IgE antibody measurement.

Results: The costs were higher for in vitro than in vivo testing. However, the clinical information obtained using recombinant reagents allowed correct identification of the sensitizing molecule.

Conclusions: Recombinant allergens for specific IgE in vitro measurement provide more reliable information for immunotherapy prescription. This should be translated into a significant reduction in the overall costs sustained by the healthcare system.

Clin Chem Lab Med 2007;45:391–5.

Keywords: allergen-specific immunotherapy; cost comparison; IgE determination; recombinant allergen; skin prick tests

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