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caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from
immunoglobulin E (IgE)-sensitized effector cells (mast cells and basophils) when cell-bound IgE
antibodies interact with allergen. In vitro serum testing for IgE antibodies provides an indication of the
immune response to allergen(s) 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(s), 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).
Useful For: Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease
and to define the allergens responsible for eliciting signs and symptoms. Testing also may be useful to
identify allergens which may be responsible for allergic disease and/or anaphylactic episode, to confirm
sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of
allergic reactions to insect venom allergens, drugs, or chemical allergens.
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.
Reference Values:
Class IgE kU/L Interpretation
0 Negative
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 > or =100 Strongly positive Reference values
apply to all ages.
Clinical References: Homburger HA: Allergic diseases. In Clinical Diagnosis and Management by
Laboratory Methods. 21st edition. Edited by RA McPherson, MR Pincus. New York, WB Saunders
Company, 2007, Chapter 53, Part VI, pp 961-971
Supersaturation Profile, Pediatric, Random, Urine
Clinical Information: Urine is often supersaturated, which favors precipitation of several crystalline
phases such as calcium oxalate, calcium phosphate, and uric acid. However, crystals do not always form
in supersaturated urine because supersaturation is balanced by crystallization inhibitors that are also
present in urine. Urinary inhibitors include ions (eg, citrate) and macromolecules but remain poorly
understood. Urine supersaturation is calculated by measuring the concentration of all the ions that can
interact (potassium, calcium, phosphorus, oxalate, uric acid, citrate, magnesium, sodium, chloride, sulfate,
and pH). Once the concentrations of all the relevant urinary ions are known, a computer program can
calculate the theoretical supersaturation with respect to the important crystalline phases (eg, calcium
oxalate).(1) Since the supersaturation of urine has been shown to correlate with stone type (2), therapy is
often targeted towards decreasing those urinary supersaturations that are identified. Treatment strategies
include alterations in diet and fluid intake as well as drug therapy, all designed to decrease the urine
supersaturation.
Useful For: Diagnosis and management of patients with renal lithiasis: -In patients who have a
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