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Milk (Allergen Specific IgE)

Milk (f2)

Test Codes

Antrim #31386, EPIC: LAB5667, SOFT: EMIL

Department

Special Testing Allergens

Specimen Collection Criteria

Collect: One Gold-top SST tube.

Twenty individual allergen assays or allergen screens can be performed on one 5 mL Gold-top SST tube. Each allergen assay requires 100 mcL of serum.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within two hours of collection.

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F).

Rejection Criteria

Plasma specimens.

Severely lipemic or hemolyzed specimens.

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of two hours.

Storage

Specimen Stability for Testing:

Centrifuged SST Tubes and Microtainers^® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers^® without Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 2 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 1 month

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

Performed

Monday – Friday.
Results available the next business day.

Reference Range

Allergy Reference Range: Less than 0.35 kU/L. 

Range (kU/L)	Class	Interpretation
Less than or equal to 0.34	0	Negative
0.35-0.69	1	Low
0.70-3.49	2	Medium
3.50-17.49	3	High
17.50-49.99	4	Very High
50.0-100.0	5	Very High
Greater than 100	6	Very High

Test Methodology

Fluorescence Enzyme Immunoassay (FEIA).

Interpretation

The allergen class may not be predictive of clinical disease in some patients. The diagnosis of allergy should be based upon patient history and clinical findings. The diagnosis of allergy should not be based upon laboratory findings alone.

Clinical Utility

A positive test result (class 1 or greater) is indicative of the presence of allergen-specific IgE and suggests an increased likelihood of allergic disease.

Clinical Disease

The major allergens of milk include alpha-, beta-, and kappa- caseins, beta-lactoglobulins, and alpha-lactalbumin which are produced in the mammary gland and gamma-casein and proteose-peptones are derived from post-translational proteoloysis (1,2). The stability of the milk allergens vary widely. Beta-lactoglobulin and alph-lactalbumin have the highest stability, however serum proteins and beta-casein are highly labile (1). Many individuals will react to more than one milk protein (1). Casein produces the greatest degree of reactivity in skin testing (68%). Beta-lactoglobulin produces the greatest degree of reactivity in oral challenges (66%). Milk intolerance is rare in adults because children often lose their sensitivity to milk over time (2).

Symptoms of milk allergy may include increased bowel sounds, abdominal bloating, nausea, watery diarrhea, abdominal cramps (colic in babies), and mouth ulcers.

Cross-reactivity has been observed between cow's milk and goat's milk. Small amount of penicillin are added to milk and can cause a reaction to sensitive individuals. Persons sensitive to cow's milk are not commonly sensitive to beef or cow dander inhalation.

Reference

1. Metcalfe, Dean D. M.D., Hugh A. Sampson, M.D., Ronald A. Simon, M.D., Food Allergy: Adverse Reactions to Foods and Food Additives. Blackwell Scientific Publications: Boston, 1991, pg. 38-39.
2. Korenblat, Phillip E., M.D. & H. James Wedner, M.D. Allergy: Theory and Practice, 2nd ed. W.B. Saunders Company: Philadelphia, 1992, pg. 516-517.

CPT Codes

86003
LOINC: 6174-7

Contacts

Last Updated

2/27/2023