There are a number of different tests which an allergist might suggest a patient take in order to determine the scale and type of insect sting allergy. However, wherever possible a detailed case history of the patient is probably just as important as any test described below.
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Skin Prick Test – the skin is pricked and a low dose of different venom is introduced onto the broken skin. The level of response is monitored and this can be an excellent way of determining the scale of allergy and the exact insect to which the patient is allergic. The test is cheap and simple but the major risk is anaphylaxis. This is a test favoured by many allergists and is considered to be the “gold standard”.
RAST Test – a blood test is taken and the levels of venom specific IgE in the blood is measured. This shows in theory the level of the allergy and the precise insect to which the patient is allergic. However there are some poor results and this test, whilst having the advantage of being outside the body, does not, in many professionals eyes, provide the same level of certainty as the Skin Prick Test.
Basophil Activation Test – this has the bonus of being functional even if the patient is on anti-histamines. The blood test must be performed within four hours of the blood being drawn and measures through a number of different staining techniques the level of activation of the allergy response cells in the blood to the allergen before and after the challenge. Instead of measuring histamine the test measures CD63 which is a marker for activated basophils (tetraspanin).
Component Resolved Diagnosis Test – This is the cutting edge of venom diagnostics and is increasingly preferred to any other blood test because it produces far few false results than the RAST test. In a nutshell the scientists have analysed in some detail the various parts of bee and wasp venom that cause the allergic reaction and can now test your blood for sensitivity to those parts. This has proven to be very accurate indeed and has taken a lot of the uncertainty out of the equation.