Position Statement

Stapel et al1 concerning testing for IgG4 against foods is a timely reminder that this issue is pervasive throughout the world. The ease of obtaining laboratory tests for suspected allergic symptoms, which then need sophisticated interpretation, is an ongoing problem. It should be stressed that the use of all tests for allergy should be supported by the scientific evidence base, when it exists. The improper use of certain tests to make diagnoses, in the absence of supporting clinical evidence, can lead to poor patient care and can have a serious adverse impact on patient quality of life. The American Academy of Allergy, Asthma & Immunology supports the EAACI Position Paper, and without reiterating the entire document, the following points deserve emphasis: 1. It is neither possible nor appropriate to use serum antibody tests to diagnose food allergy in the absence of a good history and possible challenge testing. 2. Serum antibody levels for IgG4 or IgE (or other IgG subclasses) indicate the presence of specific antibody but do not make a diagnosis. The presence of antibody does not indicate disease. 3. It is common for primary care providers to order serum antibody tests (usually IgE) fo