Allergic evaluation and management of the atopic patient

Atopy in defined as an inherited predisposition to produce immunoglobulin E (IgE) antibodies in response to natural exposure to minute quantities of environmental allergens, manifesting clinically with atopic diseases. These include food allergy, eczema, asthma, seasonal and persistent rhinitis and urticaria. Not all allergic diseases are atopic in nature.Examples of non-atopic allergic diseases include allergy to drugs (e.g. penicillin), venoms (e.g. bee sting allergy) and some occupational allergies.The cornerstone of the clinical diagnosis of any atopic disease in a detailed history, followed by specific IgE sensitivity testing. This requires knowledge of the patient's presenting symptoms, his family history and a careful knowledge of the environment in which the patient lives or works.History taking is time consuming, but always rewarding and the most cost effective part of the clinical evaluation. The history guides the clinician as to the most appropriate clinical or laboratory test and can ...