1st order laboratory parameters – obligatory laboratory tests.
- Allergy diagnostics – Various allergy tests can be performed to determine whether mold allergy exists:
- Prick test (skin test): in this test, the allergens in question are applied in droplet form to the forearms. A thin needle is then used to slightly nick the skin at these sites, allowing the test solution to enter the skin. This is only slightly painful – only the top layer of skin is scratched. If erythema (reddening of the skin over a large area) or wheals appear after about 15 to 30 minutes, the test is positive. Note: A positive test result only indicates that sensitization to the substance has occurred. However, the substance does not have to be the triggering allergen. Therefore, other examinations such as the provocation test usually follow to confirm the result. [Correlation between skin test and specific IgE is poor.]
- Antibody detection
- Specific IgE antibodies to specific allergens (in the case of type I sensitization). [The detection of specific IgE means that there is specific sensitization to corresponding allergens. However, like a positive reaction in the skin test, this is just as little the same as a clinically relevant allergy!]This method is called RAST (Radio Allergo Sorbent Test, RAST test). However, this complex test can only be performed by specialized laboratories, but is reimbursed by health insurance companies.
- Specific IgG antibodies – in the case of exogenous allergic alveolitis (very rare in non-workplace indoor exposure)The determination of specific IgG antibodies in connection with the diagnosis of mold allergy of the immediate type (type 1 allergy) has no diagnostic significance is therefore not recommended.
- Provocation test As a third option, a so-called provocation test can be performed. Here, for example, nasal sprays containing the allergen are sprayed on the nasal mucosa (= nasal provocation test, NPT) to provoke as a result an allergic immediate reaction (type I allergy) with corresponding typical complaints under controlled conditions.[The clinical relevance of sensitization with molds can be demonstrated by specific exposure testing (conjunctival/nasal/bronchial provocation with mold allergens)].
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Cytology – assessment of cells from a smear.
- Histology
- Bacteriology, mycology – detection of bacteria or fungi.
- Indoor air analysis for pollutants
- Nonspecific provocation test with histamine
Further notes
- “Indoor mold measurements for medical indication are rarely useful. As a rule, in the case of visible mold infestation, both a quantitative and a qualitative determination of the mold species can be dispensed with. Rather, the causes of the infestation are to be clarified, then infestation and primary causes are to be eliminated.”
- Lymphocyte transformation tests (LTTE) for mold are not indicated as diagnostic procedures.
