Pollen Allergy: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests.

  • Allergy diagnostics – Various allergy tests can be performed to determine whether hay fever is present:
    • In the prick test (skin test; method of choice): in this test, the allergens in question are applied in droplet form to the forearms. A thin needle is then used to lightly nick the skin at these sites, allowing the test solution to enter the skin’s interior. 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. However, 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 investigations such as the provocation test usually follow to confirm the result.
    • Antibody detection Furthermore, there is the possibility of a blood test: Ig-E detection (= total IgE or allergen-specific IgE in serum) – if an allergy of the immediate type (type I) is suspected; especially if a skin test (see above) is difficult to perform or the patient would be endangered by it. This method is called RAST (radio-allergo-sorbent test).
    • Provocation test As another option, a so-called provocation test can be performed. Here, for example, nasal sprays, which contain pollen suspected of allergy, are sprayed on the nasal mucosa (= nasal provocation test, NPT). Since hay fever is an allergy of the immediate type, the typical hay fever symptoms occur immediately if the allergy is present. In NPT, after the allergen has been applied, the altered nasal air patency is measured using anterior rhinomanometry (measurement and analysis of the volume flow based on the air passing through the nasal cavity during breathing). Another provocation test exploits the conjunctival response to allergen exposure. This test is useful as a predictor of allergic rhinoconjunctivitis symptoms during a pollen season.

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