Allergy and intolerance
IgE antilichamen amandel
Antibodies against almond protein; shows whether the immune system is sensitive to almond, not whether you get symptoms from it.
Everything about this testWhat it measures
Almond is the seed of the almond tree, a relative of peach and plum. Almond is found in many products, such as marzipan, almond paste, almond macaroons, pastries, muesli and almond drink, and sometimes in cosmetics; almond must be listed as an allergen on food packaging. This test measures the amount of IgE antibodies against the proteins in almond in the blood, in kU/l. The body only makes these antibodies after it has previously been in contact with the allergen; this is called sensitization.
- Sensitization to almond: the body has made IgE antibodies against almond
- Support in working out a suspected allergy to almond, together with the history of the symptoms
- A possible explanation for itching or a burning feeling in the mouth or throat after eating almond in people with hay fever from birch pollen
High
A value above the cut-off means that you have IgE antibodies against almond: sensitization. That is not the same as an allergy. In people with hay fever from birch pollen, a positive result can also come from a cross-reaction, with mainly itching or a burning feeling in the mouth or throat; according to Stichting Voedselallergie, a nut allergy linked to birch pollen is usually milder. For nuts, the Dutch medical specialists' guideline (FMS) still recommends further testing for such mouth symptoms after a small amount, because a larger amount can cause a severe reaction and mouth symptoms can be the start of one. Someone who reacts to one type of nut often also reacts to other nuts. The level of the value says little about how severe a reaction would be.
Low
A value below the cut-off means that no IgE antibodies against this allergen were found. An IgE-mediated allergy to this allergen is then much less likely, although it is not completely ruled out. Symptoms can also come from another allergen that was not tested, or have a non-allergic cause.
If your result is abnormal
The GP mainly looks at the history: which symptoms, when and where they occur and after contact with what. With a positive result and matching symptoms, advice usually follows to limit contact with the allergen and, if needed, medication. With a severe reaction, in case of doubt or with symptoms that are not brought under control this way, a referral to an allergist, pediatrician, ENT specialist or lung specialist may follow.
Reliability
A positive IgE result shows sensitization, not allergy: it only says that there are antibodies, not that you get symptoms from them. The Dutch medical specialists' guideline (FMS) on upper airway allergy says this literally and recommends choosing a test for single allergens based on the history of the symptoms; for food allergy, the FMS guideline on food challenge testing calls the history of the symptoms the cornerstone of diagnosis and a food challenge in hospital the gold standard. The result therefore only means something if it fits when, where and after contact with what you get symptoms. A positive result without symptoms is not treated.
Limitations
- Sensitization without symptoms is common; the result can only be interpreted together with the history of the symptoms.
- Related allergens can recognize each other's antibodies (cross-reaction), for example pollen and nuts or fruit; a positive result then does not mean that this particular allergen causes the symptoms.
- The test measures all proteins from the allergen source together; testing for individual proteins (components) can say more in case of doubt.
- Laboratories use different measurement methods and cut-off values; results from different labs cannot be compared one to one.
How common is this
According to Stichting Voedselallergie, 1 to 2 in 100 people in the Netherlands have a nut allergy, both children and adults; hazelnut and walnut top the list. Nuts can cause severe reactions. Someone who reacts to one type of nut often also reacts to other nuts. Allergy to almond is less common than allergy to hazelnut or walnut.
Who is this useful for
Useful with a clear reaction shortly after eating almond or a product containing almond, such as marzipan, or with mouth symptoms after a small amount of almond. Someone with hay fever who has often eaten larger amounts of almond with only mild itching in the mouth almost certainly has a cross-reaction according to the FMS guideline and usually needs no further testing. In people who eat almond normally without symptoms, the test adds nothing.
Sources
- NVKC, allesovertesten.nl: Allergie (RAST)
- FMS Richtlijnendatabase: Allergie van de bovenste luchtwegen, module Aanvullende diagnostiek
- FMS Richtlijnendatabase: Voedselprovocatie, module Plaatsbepaling diagnostiek voedselallergie
- Thuisarts.nl: Ik heb allergie
- NHG-Standaard Voedselovergevoeligheid en coeliakie (M47)
- Stichting Voedselallergie: Noten
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results