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SPB<br />

8892<br />

PDRP<br />

82796<br />

Laboratory Methods. 21st edition. Edited by McPherson RA, Pincus MR. WB Saunders, Publ, New York,<br />

Chapter 53, Part VI, pp. 961-971, 2007<br />

Pigeon Breeders Disease Serology, Serum<br />

Clinical Information: Avian proteins, including antigens in pigeon droppings, are a causative agent<br />

of hypersensitivity pneumonitis (HP). While the immunopathogenesis of HP is not known, several<br />

immune mechanisms are postulated to play a role, including both cellular and humoral mechanisms.(1)<br />

Useful For: Evaluation of patients suspected of having hypersensitivity pneumonitis induced by<br />

exposure to pigeon droppings<br />

Interpretation: Elevated concentrations of IgG antibodies to pigeon droppings are consistent with the<br />

diagnosis of hypersensitivity pneumonitis caused by exposure to this antigen. Negative results do not rule<br />

out the disease.<br />

Reference Values:<br />

> or =16 years: < or =53.3 mg/L<br />

Clinical References: 1. Fink JN, Zacharisen MC: Hypersensitivity pneumonitis. In Allergy<br />

Principles and Practice. Vol. 1. 5th edition. Edited by E Middleton Jr, CE Reed, EF Ellis, et al. St. Louis,<br />

MO, Mosby Year Book, Inc., 1998, Chapter 69 2. Anderson E, Jacob GL, Roberts GD, Homburger HA:<br />

Comparative evaluation of enzyme immunoassay and immunodiffusion for detection of IgG antibodies to<br />

hypersensitivity pneumonitis antigens. Poster Presentation, AAAAI Annual Meeting, San Diego, CA<br />

March 3-8, 2000. J Allergy Clin Immunol 2000;105:S304<br />

Pigeon Droppings, IgE<br />

Clinical Information: Clinical manifestations of immediate hypersensitivity (allergic) diseases are<br />

caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from<br />

immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE<br />

antibodies interact with allergen. In vitro serum testing for IgE antibodies provides an indication of the<br />

immune response to allergen(s) that may be associated with allergic disease. The allergens chosen for<br />

testing often depend upon the age of the patient, history of allergen exposure, season of the year, and<br />

clinical manifestations. In individuals predisposed to develop allergic disease(s), the sequence of<br />

sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and<br />

bronchospasm) in infants and children less than 5 years due to food sensitivity (milk, egg, soy, and wheat<br />

proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to<br />

sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).<br />

Useful For: <strong>Test</strong>ing for IgE antibodies may be useful to establish the diagnosis of an allergic disease<br />

and to define the allergens responsible for eliciting signs and symptoms. <strong>Test</strong>ing also may be useful to<br />

identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm<br />

sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of<br />

allergic reactions to insect venom allergens, drugs, or chemical allergens.<br />

Interpretation: Detection of IgE antibodies in serum (Class 1 or greater) indicates an increased<br />

likelihood of allergic disease as opposed to other etiologies and defines the allergens that may be<br />

responsible for eliciting signs and symptoms. The level of IgE antibodies in serum varies directly with the<br />

concentration of IgE antibodies expressed as a class score or kU/L.<br />

Reference Values:<br />

Class IgE kU/L Interpretation<br />

0 Negative<br />

1 0.35-0.69 Equivocal<br />

2 0.70-3.49 Positive<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1418

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