Allergology – Immunology

Allergia, immunológia - Svábhegyi Gyermekklinika

ALLERGY - symptoms, treatment

Disturbed sleep, clogged nose, recurring cough, itching eye, lacrimation, erythema, itchy rashes after eating certain foods, eczema, perhaps even diarrhea – these could all be symptoms indicating some kind of allergy, which has to be treated. The faster we reach out to a pediatric allergologist, the faster the reasons behind these unpleasant symptoms can be uncovered, and the faster they can be cured.

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Although allergic reactions can vary patient to patient, their cause is always the same; they are a result of exposure to a certain substance, called the allergen, which our bodies do not know how to cope with, and cannot tolerate. The most important part of dealing with symptoms that indicate an allergy is thus identifying  the allergen.

Our doctors are nationally acclaimed, experienced specialists. In pursuit of the most accurate diagnosis possible, our institution uses a cutting edge ,procedure that is unique in the country (Component Resolved Diagnostic – CRD). This way we can not only determine the exact cause of the allergy, but also its severity in each individual case based on a simple blood sample.

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What is the most common kind of allergy?

An allergy is the overly excessive reaction of the immune system to various substances that enter the organism through the airways, the skin, or the alimentary tract. Common examples for allergens include airborne pollens (such as the aggressive ragweed), animal fur (mostly feline), dust mites (which mainly cause symptoms during nights in heating season), and the and ever-present mildew. Allergic reactions can also be caused by certain animal poisons (insect bites), microorganisms, foodstuffs, additives, colorings, flavor enhancers, medicine, chemicals, heavy metals, just to name the most common ones.

In the case of an allergic reaction IgE (Immoglobulin E – antibody) molecules circulating in the blood connect to certain cells, making them release histamine into the bloodstream. Histamine is one of the most important aggressive chemicals that cause mucous membranes (in the nose, the ocular conjunctiva, the bowels, the pharynx, and the lungs) to be inflamed. This is the origin of unpleasant allergic reactions such as a runny or clogged nose, itchy eyes and nose, lacrimation, gripes and diarrhea, or more uncommonly, coughing and breathing difficulty.

The most wide-spread medicines (antihistamines) act by connecting to the surface of receptor cells, stabilizing them, thereby preventing histamine being released from them and causing an allergic reaction.

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How early in life can allergic reactions appear?

During the fetal state, there can be various causes for allergies apart from hereditary factors, such as maternal pollen allergy, the mother’s active or passive smoking, or her breathing polluted metropolitan air.

A characteristic infantile allergic reaction is eczema, or atopic dermatitis. It is an extremely unpleasant disease that appears mainly in a child’s arm- knee- or elbowpits, but can also manifest itself on their face, knee, or sometimes even on their entire body, and comes with itching, erythema, peeling, and in rare cases the thickening of the skin. In certain cases, it can be caused by the mother’s excessive consumption of dairy products, by feeding the baby lactose-based infant nutrition due to lack of breast milk, or by antibiotics received as a new-born for curing infections such as streptococcus.

The course of an examination – the doctor has to know every antecendent.

While a child used to have to spend days in the hospital for a full allergy examination to be conducted, currently – while adhering to medical protocol – this can now be done in outpatient care. The family can return home with a therapy suggestion aimed at alleviating symptoms and other practical advice even after the first visit.

The course of an examination - what happens in doctor’s consulting room?

  • The allergologist has to know every antecendent, therefore, during his/her interview he can inquire about details that are independent of the patient’s current symptoms (their breast-feeding habits, birthweight, medication, or course of development), and asks about the family’s medical history, which could indicate hereditary predisposition toward certain allergies.
  • After this follows the evaluation of current complaints. Information from the parents concerning the child’s allergic symptoms, their frequency and nature, and about previously used medication is of paramount importance.
  • While inquiring about the patient’s complaints, the doctor also gets a line on both the possibility of cross-allergies (4. subtext) and maladies frequently associated with allergies such as eczema or asthma.
  • After establishing the patient’s medical history and symptoms, the allergologist examines the child, then formulates a checkup plan based on all the available information, which he/she also discusses with the parents.
  • Our institution has all the necessary diagnostic tools at its disposal to conduct any required tests in as short a while as a couple of hours – all of them in ambulantory manner – and begin personalized treatment immediately after diagnosis. As per general protocol, the examinations are as follows: blood test, skin test, spirometric examination, otorhinolaryngological inspection, examining the flow of air inside the naval cavities, and, if necessary, stress tests and electrocardiogram.
  • We supplement medical treatment with lifestyle (such as dietary and exercise-related) advice in all cases.

One blood test is enough! A unique way of examining allergies – Component Resolved Diagnostic (CRD) test (tryptase measurement).

When examining allergic symptoms, determining which component of the allergen causes them is of paramount importance. Traditional allergy tests (such as the blood and skin tests) do not examine the chemical components of an allergen (for instance peanut) separately. Instead they test whether the entire nut itself elicits an allergic reaction. Therefore, these tests are unable to forecast the severity of the allergic reaction, because there is no way of telling to which component of the peanut the organism is allergic to, and thus how much of it a peanut contains. It has only been a couple of years since testing allergies by components has become possible, and today only food allergies and respiratory allergies caused by insect bites can be examined in this manner.

Allergens used in skin tests (pollen, foodstuffs) have several components. Thus, with the above-mentioned cutting edge method, we can even determine which constituent, and to what extent, is responsible for the allergy. Component Resolved Diagnostic allergy testing is based on the more widely-performed Immunoglobulin E (IgE – antibody) inspection, however the reagent used for CRD tests is much more sensitive, and yields more reliable and accurate results. This accuracy allows for patients to circumvent dietary and other inconvenient lifestyle changes, and it can also forecast the success of immune therapy. The test is actually a simple blood test.

We also suggest performing this test if an allergic reaction is triggered in the following situations:

  • after an insect bite
  • after taking medication
  • after applying local anesthetics
  • during minor surgery
  • during contrast radiography
  • in the case of a swelling of the face, lips or tongue
  • in case of returning hives
  • if you have never experienced an allergic reaction to any of these, but spend a lot of time in nature or travelling, like to try new kinds of food or are about to undergo surgery or an examination that involves the injection of contrast material.

The test can help to identify the causes of allergic reactions that result from physical stress, sudden changes in temperature, or consumption of exotic foods, accompanied by rashes.

The advantages of Component Resolved Spec IgE Diagnostics – CRD Phadia 250 automatic:

  • increases diagnostic accuracy
  • more precise evaluation of the effectiveness of immune therapies
  • better forecast of cross-reactions
  • less false diagnoses and pointless dieting
  • improving quality of life
  • better chances of foretelling the consequences of allergic reactions (for instance predicting the probability of an anaphylaxic shock in case of a peanut allergy)

Dor patients suffering from more serious food allergies, taking the test is highly recommended. (Such severe allergic reactions are, for instance, swelling of the face, lips or tongue, hives all over the body, difficulty to breathe, an asthma attack, blacking out, or even circulatory problems threatening loss of life – anaphylaxic shock).

Skin test

We drip solutions that contain essences of different allergens onto the skin of the clean, dry forearm, along with the tinctures that serve as control. With a special tool, we make way for the solutions to seep under the uppermost layer of the skin, and in 20 minutes, the result of the test can be seen on the skin. The resulting swelling and erythema shows which allergen can play a part in sustaining the allergic symptoms.

Skin tests can be conducted even under the age of three, but the results are difficult to evaluate and are rarely definitive due to the nature of infantile skin. Above the age of three, however, skin tests are a suitable and widely-used way of diagnosing patients. If there are no positive reactions to any of the applied solutions, yet the symptoms point towards an allergy, the allergologist will suggest a blood test.

BLOOD TEST (specific IgE examination)

With the blood test, we measure the sum of all IgE (Immunoglobulin E) in the blood as well as specific IgE antibody serum levels. The number of these protein molecules increases in the bloodstream in case of an allergy. The test can be used to confirm and identify both food and respiratory allergies.

Under the age of three, in certain cases it can be important to conduct a specific IgE blood test, because the skin test does not always yield a definite result.

What you need to know about “cross-allergy”

All plants that cause allergies are made up of a mixture of different kinds of allergen proteins. Some of these proteins are specific to the plant, while others can be found in multiple members of the flora; plants, fruits or even vegetables. For example, certain constituent proteins of ragweed are also present in melons, birch contains some that apples also do, and mugwort and celery also have some in common. We call these compounds cross-allergens. Being allergic to some of them means that one is also allergic to certain fruits or vegetables.

Specialists in component resolved diagnostic testing at our institution:

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Contacts
  • Address: 1037 Budapest, Bokor u. 17-21. II. floor
  • Phone: +36 1 44 33 200
  • Fax: +36 1 395 8363 
  • Email: gondoskodas@svabhegy.eu
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Our clinic is committed to complying with the obligations relating to data processing and management stipulated in the Fundamental Law of Hungary, in the General Data Protection Regulation (EU) 2016/679 of the European Parliament and of the Council, in Act CXII of 2011 (on the right of informational self-determination and  freedom of information) and in Act LXIII of 1992 (on the protection of personal data and the publicity of data of public interest).

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