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HelpTest Code FOOD8 Food-Nut Panel # 1, Serum
Reporting Name
Food-Nut Panel # 1Useful For
Establishing a diagnosis of an allergy to almond, brazil nut, coconut, hazelnut, and peanut
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response and/or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
Testing for IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.
Testing Algorithm
Includes testing for almond, brazil nut, coconut, hazelnut, and peanut allergen.
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
This test uses a pooled allergen reagent; therefore, the multi-allergen Immunocap (panel cap) is reported with a single qualitative class result and concentration. This is the appropriate first-tier test for allergic disease.
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL for every 5 allergens requested
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.3 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days |
Special Instructions
Reference Values
|
Class |
IgE kU/L |
Interpretation |
|
0 |
<0.10 |
Negative |
|
0/1 |
0.10-0.34 |
Borderline/equivocal |
|
1 |
0.35-0.69 |
Equivocal |
|
2 |
0.70-3.49 |
Positive |
|
3 |
3.50-17.4 |
Positive |
|
4 |
17.5-49.9 |
Strongly positive |
|
5 |
50.0-99.9 |
Strongly positive |
|
6 |
≥100 |
Strongly positive |
Reference values apply to all ages.
Day(s) Performed
Monday through Friday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86003
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| FOOD8 | Food-Nut Panel # 1 | 46708-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| FOOD8 | Food-Nut Panel # 1 | 46708-4 |
Clinical Information
Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with an allergen.
In vitro serum testing for IgE antibodies provides an indication of the immune response to allergens that may be associated with allergic disease.
The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. In individuals predisposed to develop allergic disease, the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Interpretation
Detection of IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be responsible for eliciting signs and symptoms.
The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.
Cautions
Testing for IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists or in patients in whom the medical management does not depend upon identification of allergen specificity.
Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and test results must be interpreted in the clinical context.
False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.
Clinical Reference
Homburger HA, Hamilton RG: Allergic diseases. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. Elsevier; 2017:1057-1070
Method Description
Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)
Report Available
Same day/1 to 3 daysSpecimen Retention Time
14 daysReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
Method Name
Fluorescence Enzyme Immunoassay (FEIA)
Forms
If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.
Highlights
This multi-allergen IgE antibody panel, combined with measurement of IgE in serum, is an appropriate first-order test for allergic disease.
It requires less specimen volume and less cost for ruling out allergic response; however, individual (single) allergen responses cannot be identified. In cases of a positive test, follow-up testing must be performed to differentiate between individual allergens in the panel.
Note: Only one result is generated for each panel.