Top-Down Approach
The top-down approach of allergy diagnosis is where the patient is seen by an allergist, skin prick tests are performed and then if necessary, the clinician orders specific IgE tests from Eurofins.
Allergy Testing Ireland
Allergic rhinitis, commonly known as hay fever, is the most prevalent allergic condition, affecting approximately 26% of people in Ireland. In addition, around 450,000 individuals in the State are living with asthma. Many children with food allergies in Ireland also experience one or more associated allergic conditions, including asthma, atopic dermatitis, allergic rhinitis, and particularly eczema.
The diagnosis of allergic disease is a complex, multi‑step process, often requiring a combination of clinical assessment and specialised diagnostic testing. A range of tools may be used to support accurate diagnosis, including:
Skin testing
- Skin prick tests
- Intradermal tests
- Patch testing
Laboratory testing
- Total IgE
- Specific IgE
- Basophil Activation Test (BAT)
These diagnostic approaches enable clinicians to identify allergic triggers accurately and guide appropriate patient management.
Comprehensive Allergy Testing Menu
The ultimate value of allergy testing depends on thorough pre‑test history‑taking and physical examination. The clinical judgement of the healthcare provider greatly influences the predictive value of allergy testing and appropriate interpretation of test results. A clinician can choose a 'Top-Down' or 'Bottom Up' approach.
Following are examples of the allergens we test. Visit our test guide for test codes, sample requirements etc. Visit Thermofisher website for allergen codes e.g. E1 is cat dander. Eurofins can build customised test panels for your clinic. Contact your local Laboratory.
| Single Allergen |
Whatever molecule the clinician suspects |
| Food Allergens |
Peanut, Hazelnut, Brazil nut, Almond, Coconut, Pork, Beef, Egg yolk, Chicken, Turkey, Cod, Shrimp, Blue Mussel, Tuna, Salmon, Oat, Corn, Sesame seed, Buckwheat, Egg White, Milk, Wheat, Soya, Tomato, Yeast, Garlic, Onion, Celery, Caraway, Mace, Cardamon, Clove, Basil, Fennel, Ginger, Anise, Orange, Apple, Cocoa, Kiwi, Melon, Banana, Grape, Crab, Strawberry, Rice |
| Occupational Allergens |
Latex, metals (nickel, cobalt), chemicals like isocyanates, Wood Dust |
| Inhalant Allergens |
Cat dander, Dog dander, Horse dander, Cow dander, Bermuda grass, Rye Grass, Timothy grass, Meadow grass, Johnson grass, Bahia grass, Hollister-Stier Labs, House dust mite (D pteronyssinus & farinae), Cockroach, Penicillium notatum, Cladosporium herbarum, Aspergillus fumigatus, Alternaria alternata, Box-elder Tree, Common Silver Birch Tree, Hazel Tree, Oak Tree, Sycamore Tree |
| Children & Young Infants Panel |
Cow's Milk, Peanuts, Hen's eggs, Soya, Wheat |
| IGg & IgG4 monitoring |
Specialised testing to support the monitoring of desensitisation and immunotherapy progress. |
Bottom-Up Approach
Eurofins offer ALEX®, a next generation test, covering 295 molecules (117 allergen extracts and 178 recombinant or high purified molecules). The Alex test results provide a broad exploration of the state of the patient’s allergen sensitisation.
ALEX® provides information on:
• Potential indication of a specific immunotherapy
• Allergy risks so as to avoid severe allergic reactions to foods
• Cross-reactivities
• The presence of an allergen that was not suspected
Helpful Tips from a Eurofins Pathologist
A positive serum specific IgE test does not necessarily indicate an allergy but is a useful indicator, to be interpreted with caution in conjunction with other clinical assessments to confirm allergy
Sensitisation vs. Allergy
A high level of specific IgE may indicate sensitization to an allergen, but it does not mean that a clinically significant allergic reaction is occurring. Some people may be sensitized without showing symptoms.
Clinical interpretation
Results should be interpreted in the light of the patient's clinical symptoms and medical history. A positive test should be interpreted in relation to allergic manifestations.
Cross-reactions
Certain IgE antibodies may react with similar allergens (structural homology between the allergens' molecular components), giving positive results that do not correspond to a real allergy to the allergen tested.
Additional tests
Additional tests, such as skin tests or symptom evaluation, are often necessary to establish a precise diagnosis.
Individual factors
Factors such as age, other pathologies and genetics can influence IgE assay results and allergic reaction.
Skin Prick Test v.s. Blood IgE Test
In vitro specific IgE measurements and Skin testing are nearly comparable in terms of results with advantages and disadvantages for both -
Cellular & Mediator Assays
In cases where sIgE results are inconclusive, Eurofins provides advanced cellular diagnostics:
- Basophil Activation Test (BAT): A functional assay for complex drug or food hypersensitivities.
- Tryptase & Histamine Levels: Vital markers for mast cell activation and systemic reactions.
Find a local laboratory
Three Rock Road, Sandyford Industrial Estate, Dublin,D18 A4C0, Ireland