After a severe allergic reaction without a known cause, a trigger should be identified if at all possible. An allergist/immunologist is the most appropriate medical professional to perform this evaluation, which may include a detailed history, physical examination, skin testing, in-vitro tests, and challenges when indicated. Future avoidance of the identified triggers should prevent subsequent anaphylactic episodes.
Diagnostic
Indirect outcome (pharmacotherapy)
See food allergy and drug allergy sections.
Diagnostic
Indirect outcome (pharmacotherapy)
Allergists and dermatologists have more expertise in caring for patients with urticaria than other specialists. Chronic urticaria often has an autoimmune pathogenesis. Consultation with an allergist/immunologist would include: reviewing possible etiologic factors (medications, supplements, dietary factors, animal exposures, physical factors), possible skin testing, possible physical challenges recommending changes in ingestants or contactants, and optimal pharmacotherapy. Allergy/immunology specialists are also knowledgeable of the minimal benefit of multiple laboratory tests in urticaria with an otherwise normal examination.
Diagnostic
Indirect outcome (avoidance, pharmacotherapy)
Allergist/immunologist training and expertise should allow appropriate differential diagnosis, determination of the need for biopsy, elimination of a specific inciting agent, and optimal pharmacotherapy1,4,5.
Diagnostic
Indirect outcome (avoidance, pharmacotherapy)
Such patients may have hereditary or acquired angioedema, paraproteinemia or B-cell malignancies. Allergist/immunologist expertise should allow optimal differential diagnosis, determination of the need for hematology/oncology evaluation, and pharmacologic therapy of hereditary or acquired angioedema due to C1 esterase inhibitor deficiency5-7.
Diagnostic
Indirect outcome (pharmacotherapy)
Allergist/immunologists are trained to diagnose and treat this disease5,8,9.
Diagnostic
Indirect outcome (pharmacotherapy)
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