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  Malaysian Society of Allergy & Immunology (MSAI)
  Diagnosing Allergy:  

  Challenge Tests

The principle of the challenge test is to reproduce the symptoms of the allergic reaction by bringing the patient into contact with the suspected allergen. If a reaction occurs, it can be concluded that this allergen is indeed the culprit of his allergy.

Bronchial challenge tests are used to provoke an attack of bronchial asthma. The patient is asked to breathe in different sorts of allergens. Or he is asked to make a physical effort (to detect "effort asthma"). Or he is subjected to cold, etc. The same principle is applied to reproduce rhinitis (nasal challenge test) or a food allergy (oral challenge test).

Challenge tests are carried out only when the medical history, skin tests, and the results of the biological examinations (specific IgE tests, etc.) give conflicting readings.

Challenge tests must be carried out in special centres, they are difficult to interpret, and they may involve risk (e.g. asthma attacks).

Challenge tests may also be used to assess the gravity of symptoms and the effect of medicines on attacks.

Research into the causes of allergies often resembles detective work. The allergen may not always be the one you think. There are sudden twists in the story; you think you have the culprit in your grasp only to suddenly discover there is an accomplice which you must also track down. Even if unravelling the mys-tery takes time, don't give up. You may not get an immediate answer, so be patient.  

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