Allergy testing: in vivo versus in vitro.


:Table 4 briefly summarizes the relative advantages and disadvantages of skin tests versus in vitro tests for detecting allergen-specific IgE. The skin test remains unexcelled as a sensitive and cost efficient test for specific IgE. The high degree of skin test sensitivity is very important when a patient must be evaluated for potentially life-threatening allergies such as to penicillin or stinging insects. The results of both skin tests and in vitro assays depend very much on the quality of the allergen extracts used for the tests. Although the quality of extracts is improving, there is still little standardization. Both skin tests and in vitro assays are difficult to quality control. Practicing allergists rely on experience, and the correlation between patient histories and skin tests results for quality control of the results. Although this system suffices for common allergens, the results for uncommon allergens may be misleading. Quality control is also difficult for in vitro tests. Participation in quality control programs, such as that being offered by the College of American Pathologists, will increase and lead to better quality and standardization of in vitro test results. At the present time, properly performed skin tests are the best available method for detecting the presence of allergen specific IgE. They are rapid, sensitive, and inexpensive on a per test basis. In vitro tests are acceptable substitutes for skin tests in some circumstances. If the patient does not have normal skin, cannot discontinue interfering medications, or is so sensitive by history that anaphylaxis seems possible, in vitro tests are preferred. In vitro tests are better when it is necessary to test a difficult patient such as a combative, mentally retarded adult. In vitro tests also have been invaluable in many allergy research studies. Physicians must remember that positive tests for allergen-specific IgE do not diagnose allergy. They only indicate the presence of IgE molecules with a particular immunologic specificity. A decision whether the specific IgE molecules are responsible for clinically apparent disease must be made by a well-trained physician. The ultimate standard for the diagnosis of allergic disease remains the combination of: (1) positive double-blind challenge, (2) the presence of specific IgE, and (3) demonstration that the symptoms are the result of IgE-mediated inflammation.


Pediatr Clin North Am


Ownby DR




Has Abstract


1988-10-01 00:00:00














  • Growing up - or not - with Gun Violence.

    abstract::Firearm injury is a leading cause of death and injury for children and adolescents, able to cause disability and interfere with normal development. Child developmental stages, variance of behavior, and mental health may all put children at risk for firearm injury or lead to increased morbidity after experiencing firea...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Schaechter J,Alvarez PG

    更新日期:2016-10-01 00:00:00

  • Chronic musculoskeletal pain in young athletes.

    abstract::Chronic musculoskeletal pain is becoming increasingly common in young athletes. When these athletes do not respond well to standard treatments, for example physical theraphy and anti-inflammatories, other diagnoses must be considered, such as reflex sympathetic dystrophy, fibromyalgia, and/or overtraining syndrome. ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Small E

    更新日期:2002-06-01 00:00:00

  • Immunodeficiency Presenting as an Undiagnosed Disease.

    abstract::Although primary immunodeficiencies typically present with recurrent, chronic, or severe infections, autoimmune manifestations frequently accompany these disorders and may be the initial clinical manifestations. The presence of 2 or more autoimmune disorders, unusual severe atopic disease, or a combination of these di...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Routes JM,Verbsky JW

    更新日期:2017-02-01 00:00:00

  • Status epilepticus.

    abstract::Status epilepticus is a serious medical emergency that requires prompt and appropriate intervention. Maintenance of adequate vital function with attention to airway, breathing, and circulation; prevention of systemic complications; and rapid termination of seizures must be coupled with investigating and treating any u...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Hanhan UA,Fiallos MR,Orlowski JP

    更新日期:2001-06-01 00:00:00

  • The Pediatric Knee and Proximal Tibia.

    abstract::Pediatric knee disorders are various and range from trauma and sports injuries to chronic overuse injuries. Because pediatric patients are different from adults, management of pediatric injuries and general knee disorders is also often different. Primary treatment regimen goals focus on a return to the previous level ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Woernle M,Fechisin JP

    更新日期:2020-02-01 00:00:00

  • Feeding Problems in Infants and Children: Assessment and Etiology.

    abstract::Feeding problems in infants and young children are common. In healthy children who are developing and growing normally, feeding problems are usually not serious and can be managed conservatively by reassuring the family and providing them with anticipatory guidance and follow-up. A majority of serious childhood feedin...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Borowitz KC,Borowitz SM

    更新日期:2018-02-01 00:00:00

  • Overcoming childhood asthma disparities of the inner-city poor.

    abstract::Asthmatic children living in low-income families in United States inner city communities continue to have disproportionately high rates of hospitalizations, emergency department visits, disability, and death. Current research implicates a combination of environmental, biologic, and disease mismanagement factors that u...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Federico MJ,Liu AH

    更新日期:2003-06-01 00:00:00

  • Late sequelae of major trauma in children.

    abstract::Traumatic injuries represent the most important threat to the health of children in the United States and are the leading cause of death after the first year of life. More than 20,000 children and young adults will die this year as a result of injury. For every child that dies, another 40 will require hospitalization ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章


    authors: Stylianos S

    更新日期:1998-08-01 00:00:00

  • Psychosocial adaptation after solid organ transplantation in children.

    abstract::The possibility of extending life with advanced medical procedures such as organ transplantation in childhood has made it possible to focus on patients' well-being in a wider perspective. They still experience a high prevalence of medical and physical disabilities, which definitively have an impact on a child's psycho...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Qvist E,Jalanko H,Holmberg C

    更新日期:2003-12-01 00:00:00

  • Pediatric rheumatic diseases.

    abstract::The rheumatic diseases of childhood are a relatively common and extraordinarily diverse group of illnesses; nevertheless, they are at least distantly related by similarities of immunodysregulation. These pathophysiologic relationships are reflected in affected children in similarities of historical, physical, and labo...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Warren RW,Perez MD,Wilking AP,Myones BL

    更新日期:1994-08-01 00:00:00

  • When Autistic Behavior Suggests a Disease Other than Classic Autism.

    abstract::Most neurodevelopmental disorders are defined by their clinical symptoms and many disorders share common features. Recently there has been an increase in the number of children diagnosed with autism spectrum disorder, although concerns have been raised about the accuracy of the reported prevalence rates. This article ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Simms MD

    更新日期:2017-02-01 00:00:00

  • Handoffs in care--can we make them safer?

    abstract::In today's complex and rapidly changing health care environments, patient harm may result if important patient information is not communicated from one health care provider to another during handoffs in care. Issues involving communication, continuity of care, and care planning are cited as a root cause in more than 8...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Streitenberger K,Breen-Reid K,Harris C

    更新日期:2006-12-01 00:00:00

  • Iron deficiency in the young athlete.

    abstract::Although overt anemia is uncommon, depletion of body iron stores is common among adolescent female athletes. Poor dietary iron intake, menstruation, and increased iron losses associated with physical training all appear to be important factors. Whether nonanemic iron deficiency can impair exercise performance is uncer...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Rowland TW

    更新日期:1990-10-01 00:00:00

  • Clinical management of type 2 diabetes in indigenous youth.

    abstract::Youth-onset type 2 diabetes is a serious public health problem for Indigenous people throughout the world. This article reviews the epidemiology, disease burden, treatment, and challenges in achieving successful clinical management of this disorder in Indigenous youth. Screening criteria and the complications and como...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Sellers EA,Moore K,Dean HJ

    更新日期:2009-12-01 00:00:00

  • New hormones in the therapeutic arsenal of chronic renal failure. Growth hormone and erythropoietin.

    abstract::Although the benefits of rhGH and r-HuEPO therapy in children with CRF and on dialysis are already significant, further study of these new additions to the therapeutic arsenal remains necessary. Data on the final adult height achieved in patients who receive rhGH are extremely important information that is as yet unav...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Warady BA,Jabs K

    更新日期:1995-12-01 00:00:00

  • Hematologic disorders of children in developing countries.

    abstract::This article outlines a few of the hematologic problems that are particular to developing countries, particularly those of the tropics. Because of globalization and the increasing movement of populations, hematologists in wealthier countries must be aware of the general patterns of hematologic change in the important ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Weatherall DJ,Kwiatkowski D

    更新日期:2002-12-01 00:00:00

  • Pediatric and adolescent gynecology for the primary care pediatrician.

    abstract::This review represents the author's personal style of practice in a new and evolving field, where the standard academic framework is still in its infancy. When there is no prior established practice to follow, good clinical care needs to come from listening very carefully to patients and empirically judging appropriat...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Craighill MC

    更新日期:1998-12-01 00:00:00

  • Tolerance: is it achievable in pediatric solid organ transplantation?

    abstract::In the clinical arena of transplantation, tolerance remains, for the most part, a concept rather than a reality. Although modern immunosuppression regimens have effectively handled acute rejection, nearly all organs except the liver commonly suffer chronic immunologic damage that impairs organ function, threatening pa...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Seyfert-Margolis V,Feng S

    更新日期:2010-04-01 00:00:00

  • Adopted children in their adoptive families.

    abstract::The adoptive process can produce unusual stresses on the child, and biologic and adoptive parents, from prenatal to postnatal life, and through the various phases of physical and pscyhological development. Because of the possibility of these children and their families falling into the "at risk" category with greater ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章


    authors: Schechter MD,Holter FR

    更新日期:1975-08-01 00:00:00

  • Every call is an opportunity. Supporting breastfeeding mothers over the telephone.

    abstract::Breastfeeding generates numerous questions. Every call about breastfeeding received over the telephone is an opportunity for health care professionals to listen and support the caller and offer factual information and advice to help the family to have an enjoyable breastfeeding experience. ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Philipp BL

    更新日期:2001-04-01 00:00:00

  • Laboratory tests in the analysis of states of dehydration.

    abstract::In an otherwise healthy child with acute dehydration known to be due to diarrhea or vomiting, the amount of deficit can best be estimated by accurate weight. Total serum protein and hematocrit provide a rough estimate of reduction in circulating blood volume, but calculation from these data will usually underestimate ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章


    authors: Bruck E

    更新日期:1971-02-01 00:00:00

  • The sleepy child.

    abstract::Disorders of excessive sleepiness are uncommon in children. When they occur, the presentation is often consistent with the developmental age of the child and does not meet either historical or laboratory criteria determined with adults in mind. Because of these differences, the true diagnosis can be missed or inadequa...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Givan DC

    更新日期:2004-02-01 00:00:00

  • Sexuality issues and gynecologic care of adolescents with developmental disabilities.

    abstract::All human beings are sexual from birth to death and all children and adolescents with or without disability or chronic illness must incorporate appropriate sexuality concepts into their processes of development from childhood to adolescence. This article considers sexuality issues and reproductive care of adolescents ...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Greydanus DE,Omar HA

    更新日期:2008-12-01 00:00:00

  • Social skills training for children with autism.

    abstract::This article summarizes the current literature on social skills training for children and adolescents with autism spectrum disorders. The article describes several different methods of social skills training, along with a summary of research findings on effectiveness. Interventions described include social skills grou...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Bohlander AJ,Orlich F,Varley CK

    更新日期:2012-02-01 00:00:00

  • Nutrition therapy for the child and adolescent with Type I diabetes mellitus.

    abstract::The author enumerates the objectives of nutritional instruction and therapy for the child with diabetes mellitus and examines some of the principles upon which this therapy is based. Also discussed are the methods used to formulate meal plans, stressing the fact that instruction and counseling in nutritional principle...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章


    authors: Arky RA

    更新日期:1984-06-01 00:00:00

  • Feeding the premature and compromised infant: gastrointestinal considerations.

    abstract::We have presented the current concepts of gastrointestinal ontogeny--the various factors governing the ontogeny of the gastrointestinal tract and the interaction and intricate relationship between different determinants. It is only through a better understanding of the development of the gut and the various factors af...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Lebenthal E,Leung YK

    更新日期:1988-04-01 00:00:00

  • Gluten-sensitive enteropathy in childhood.

    abstract::Genetic and environmental factors (breast feeding, probably viral infections) play a role in the expression of the disease. Prevalence of GSE in childhood did not substantially decrease in the last 15 years in all European countries, where GSE is still more common in infantile age and presents frequently gastrointesti...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Auricchio S,Greco L,Troncone R

    更新日期:1988-02-01 00:00:00

  • The poisoned child in the pediatric intensive care unit.

    abstract::Acutely poisoned children remain a common problem facing pediatricians working in acute care medicine in the United States and worldwide. The management of such children continues to be challenging, and their care has evolved throughout the years. The concept of gastric decontamination in acute poisoning has significa...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Hanhan UA

    更新日期:2008-06-01 00:00:00

  • Gastroesophageal reflux, eosinophilic esophagitis, and foreign body.

    abstract::Even though chest pain in children is a common complaint, an underlying gastrointestinal cause is rare. The four common gastrointestinal conditions that present with chest pain include eosinophilic esophagitis, gastroesophageal reflux disease, esophageal dysmotility, and foreign body ingestion. Other than ingestion of...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章,评审


    authors: Garza JM,Kaul A

    更新日期:2010-12-01 00:00:00

  • Continuous renal prosthetic therapy in acute renal failure: an overview.

    abstract::The technology surrounding the treatment of acute renal failure has been traditionally left in the realm of dialysis. The use of peritoneal dialysis for the neonate or small infant and the often difficult use of hemodialysis in larger children and adolescents have been the mainstay of support. Not infrequently, howeve...

    journal_title:Pediatric clinics of North America

    pub_type: 杂志文章


    authors: Paganini EP

    更新日期:1987-02-01 00:00:00