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HelpTest Code INSEC Stinging Insects Allergen Profile, Serum
Reporting Name
Stinging Insects Allergen ProfileUseful For
Establishing a diagnosis of an allergy to honeybee, yellow jacket, wasp, yellow faced hornet, and white-faced hornet venoms
Defining the allergen responsible for eliciting signs and symptoms
Identifying allergens:
-Responsible for allergic response and/or anaphylactic episode
-To confirm sensitization prior to beginning immunotherapy
-To investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HBV | Honeybee Venom, IgE | Yes | Yes |
| YJV | Yellow Jacket Venom, IgE | Yes | Yes |
| WSPV | Wasp Venom, IgE | Yes | Yes |
| YFHV | Yellow Faced Hornet Venom, IgE | Yes | Yes |
| WFHV | White Faced Hornet Venom, IgE | Yes | Yes |
Testing Algorithm
This profile includes testing for honeybee, yellow jacket, wasp, yellow faced hornet, and white-faced hornet venoms.
Method Name
Fluorescence Enzyme Immunoassay (FEIA)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumOrdering Guidance
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.8 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
For 1 allergen: 0.3 mL
For more than 1 allergen: (0.05 mL x number of allergens) + 0.25 mL deadspace
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days |
Reject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
Special Instructions
Reference Values
|
Class |
IgE kU/L |
Interpretation |
|
0 |
<0.10 |
Negative |
|
0/1 |
0.10-0.34 |
Borderline/equivocal |
|
1 |
0.35-0.69 |
Equivocal |
|
2 |
0.70-3.49 |
Positive |
|
3 |
3.50-17.4 |
Positive |
|
4 |
17.5-49.9 |
Strongly positive |
|
5 |
50.0-99.9 |
Strongly positive |
|
6 |
≥100 |
Strongly positive |
Reference values apply to all ages.
Day(s) Performed
Monday through Friday
CPT Code Information
86003 x 5
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| INSEC | Stinging Insects Allergen Profile | 94593-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| HBV | Honeybee Venom, IgE | 6844-5 |
| WFHV | White Faced Hornet Venom, IgE | 6280-2 |
| WSPV | Wasp Venom, IgE | 13176-3 |
| YFHV | Yellow Faced Hornet Venom, IgE | 6288-5 |
| YJV | Yellow Jacket Venom, IgE | 6740-5 |
Clinical Information
Clinical manifestations of immediate hypersensitivity (allergic) diseases are caused by the release of proinflammatory mediators (histamine, leukotrienes, and prostaglandins) from IgE-sensitized effector cells (mast cells and basophils) when cell-bound IgE antibodies interact with an allergen.
In vitro serum testing for IgE antibodies provides an indication of the immune response to allergen that may be associated with allergic disease.
The allergens chosen for testing often depend upon the age of the patient, history of allergen exposure, season of the year, and clinical manifestations. In individuals predisposed to develop allergic disease, the sequence of sensitization and clinical manifestations proceed as follows: eczema and respiratory disease (rhinitis and bronchospasm) in infants and children younger than 5 years of age due to food sensitivity (milk, egg, soy, and wheat proteins) followed by respiratory disease (rhinitis and asthma) in older children and adults due to sensitivity to inhalant allergens (dust mite, mold, and pollen inhalants).
Interpretation
Detection of IgE antibodies in serum (class 1 or greater) indicates an increased likelihood of allergic disease as opposed to other etiologies and defines the allergens responsible for eliciting signs and symptoms.
The level of IgE antibodies in serum varies directly with the concentration of IgE antibodies expressed as a class score or kU/L.
Cautions
Testing for IgE antibodies is not useful in patients previously treated with immunotherapy to determine if residual clinical sensitivity exists, or in patients in whom the medical management does not depend upon identification of allergen specificity.
Some individuals with clinically insignificant sensitivity to allergens may have measurable levels of IgE antibodies in serum, and test results must be interpreted in the clinical context.
False-positive results for IgE antibodies may occur in patients with markedly elevated serum IgE (>2500 kU/L) due to nonspecific binding to allergen solid phases.
Method Description
Specific IgE from the patient's serum reacts with the allergen of interest, which is covalently coupled to an ImmunoCAP. After washing away nonspecific IgE, enzyme-labeled anti-IgE antibody is added to form a complex. After incubation, unbound anti-IgE is washed away, and the bound complex incubated with a developing agent. After stopping the reaction, the fluorescence of the eluate is measured. Fluorescence is proportional to the amount of specific IgE present in the patient's sample (ie, the higher the fluorescence value, the more IgE antibody is present).(Package insert: ImmunoCAP System Specific IgE FEIA. Phadia; Rev 06/2020)