Specialised Testing
SPIROMETRY
Spirometry includes the use of pulmonary measurements made with a spirometer to evaluate airway
obstruction, and if so, whether it is reversible with a bronchodilator. It is mandatory to diagnose and
characterize asthma severity.
obstruction, and if so, whether it is reversible with a bronchodilator. It is mandatory to diagnose and
characterize asthma severity.
Spirometry is recommended:
1. At the initial visit
2. After treatment is initiated, and symptoms and peak expiratory flow have stabilized, to
document attainment of (near) "normal" airway function
3. At least once yearly to assess maintenance of airway function, regardless of medication (changes).
4. To evaluate the response to a change in therapy.
1. At the initial visit
2. After treatment is initiated, and symptoms and peak expiratory flow have stabilized, to
document attainment of (near) "normal" airway function
3. At least once yearly to assess maintenance of airway function, regardless of medication (changes).
4. To evaluate the response to a change in therapy.
PRICK/ SCRATCH TESTING
The prick/puncture test is used to confirm hypersensitivity to a wide variety of allergens. It is the most
convenient and specific method for detecting IgE antibodies. This test is done on the surface of the skin. A tiny
amount of allergen is scratched across or lightly pricked into the skin. If you have an allergy, the specific
allergens that you are allergic to will cause a chain reaction to begin in your body.
convenient and specific method for detecting IgE antibodies. This test is done on the surface of the skin. A tiny
amount of allergen is scratched across or lightly pricked into the skin. If you have an allergy, the specific
allergens that you are allergic to will cause a chain reaction to begin in your body.
INTRADERMAL TESTING
Intradermal allergy testing is another method of skin testing to help determine whether an
individual is allergic to a specific allergen. The test involves injection of a small amount of the
suspected allergen under the surface of the skin. After about 20 minutes the area is examined for a
reaction at the site. A typical reaction looks like a small hive with swelling and redness. The
intradermal test is more sensitive than the skin prick test for insect venoms and certain drugs.
PATCH TESTING
A patch test is a diagnostic method used to determine which specific substances cause allergic
inflammation of a patient's skin. Patch testing helps identify which substances may be causing a
delayed-type allergic reaction in a patient, and can identify allergens not identified by blood testing
or skin prick testing . It is useful in cosmetic, hair dye and topical drug reactions as well as certain
foods and environmental exposure reactions.
FOOD CHALLENGES
An oral food challenge (OFC), or feeding test, is a medical procedure in which a food is eaten slowly,
in gradually increasing amounts, under careful medical supervision, to accurately diagnose or rule
out a true food allergy. It is also useful for confirming resolution or remission of food allergies.
DRUG CHALLENGES
A drug challenge test is done to find out whether someone is allergic to a particular drug
(medicine). It is therefore carried out under close medical supervision. There are different
ways to do this test oral, injectable and infused, but we usually start by giving a very low
dose dilution of the medicine being tested, and then progressive dose(s) every 20-30
minutes thereafter. A drug challenge usually lasts around four to six hours.
VACCINE CHALLENGES
Vaccines are known to trigger allergic reactions due to a variety of different ingredients. The
incidence is around one in a million or more. Allergist Immunologists are trained to exactly
diagnose what causes such reactions through skin tests and blood tests as well as
administering injected vaccine challenges as per pre-planned protocols.
EXHALED NITRIC OXIDE (FeNO) MEASUREMENT
A FeNO test or exhaled nitric oxide test, in patients with allergic or eosinophilic asthma, is a way to
determine how much lung inflammation is present and how well medicines are working for this
inflammation. Nitric oxide is a gas produced by cells involved in the inflammation associated with
allergic asthma. The FeNO test, is performed using a portable device that measures the level of nitric
oxide in parts per billion (PPB) in the air you slowly exhale out of your lungs. It is different from most
lung function tests in that you need to blow slowly and steadily, not hard and fast, to get an accurate
measurement.
BRONCHOPROVOCATIVE CHALLENGES
Bronchoprovocation tests measure lung function after exposure to common asthma symptom
triggers. Asthma triggers used in the test include cold air, exercise, or inhaling a mist containing a
substance that causes lung constriction in people with asthma. These have to be done carefully
under supervision.
RHINOSCOPY
Rhinoscopy, or Fiberoptic Rhinolaryngoscopy, is the procedure for examining the nose and throat
area for a patient. During the procedure, a doctor uses a rhinoscope to inspect the inside of the
nose, eustachian tube openings, adenoids, throat and vocal cords
