¿Qué análisis se realizan en Sangre para diagnosticar la alergia?

Los análisis de sangre más corrientes para el estudio de alergia son la IgE total y la IgE específica. A esta última se la llama también RAST, CAP, ELISA, y por algún otro nombre.

¿Los medicamentos influyen en los análisis de sangre?
Los medicamentos no suelen influir en los análisis de sangre, así que puede uno tomarse la medicación que necesite para sus síntomas sin retrasar los análisis. De todos modos, coménteselo al especialista cuando le comuniquen los resultados de la analítica.

¿Qué indica la IgE total?
Todas las personas tienen alguna cantidad de IgE total. La IgE total se interpreta más bien como la predisposición para desarrollar alergia. No indica alergia concreta a alguna sustancia determinada, sino la facilidad en general para hacerse alérgico a cualquier sustancia. Esta predisposición es de tipo hereditario familiar.
Las personas con IgE total alta tienen más facilidad para desarrollar alergia, pero no obligatoriedad. Algunas personas con facilidad no desarrollarán alergia nunca. Por el contrario, algunas personas que en principio no tienen gran facilidad sí que pueden acabar desarrollando alergia a alguna sustancia concreta.

¿Cuál es el valor normal de IgE total?
Depende de la edad. Va subiendo desde el nacimiento hasta la edad adulta. La IgE se mide en U/mL o kU/L; el valor numérico es el mismo para ambas. Valores que en un niño de 10 años se consideran normales pueden ser muy altos para un niño de 10 meses. Se han de consultar tablas con valores de referencia para cada edad.

¿Qué indica la IgE específica?
Los análisis de IgE específica también pueden denominarse RAST, CAP o UniCAP, ELISA y algún otro nombre. Estos análisis miden si en la sangre del paciente hay IgE específica contra un alergeno concreto. Las personas sin alergia no tienen cantidades detectable de IgE frente a, por ejemplo, la caspa de gato. Si en la sangre del paciente se encuentra IgE frente a la caspa de gato decimos que ese paciente se encuentra sensibilizado frente a los gatos.
Así, la IgE total valora la predisposición alérgica general, mientras que la IgE específica valora la alergia concreta frente a un alergeno determinado e identificado.

¿Qué alergenos se estudian con la IgE específica?
Igual que con las pruebas de piel, la IgE específica en sangre se estudia por alergenos individuales. Un poco de sangre para estudiar un alergeno, más sangre para varios alergenos, mucha sangre para muchos alergenos. El especialista decide cuáles se estudian en concreto por los datos del historial del paciente y por las sospechas que le comuniquen.
Algunos análisis de IgE en sangre estudian una mezcla de varios alergenos, pero todos mezclados, no de manera individual.
Otro método de análisis (por microarrays) estudia de manera individual 85 alergenos con una cantidad mínima de sangre. Este método está disponible en muy pocos laboratorios.

¿Cuál es el valor normal de IgE específica?

El valor normal de IgE específica se mide en kU/L o U/mL: la cifra numérica es la misma para ambas. También se mide en clases. Las personas no sensibilizadas tienen valores indetectables de IgE específica. Si no se tiene IgE se dice que es negativa; si se dice que es positiva significa que hay IgE presente. Los valores más frecuentemente usados se ven en la tabla siguiente.

Niveles de IgE específica

kU/L ó U/mL Clase Interpretación
Menos de 0,35 0 Normales o negativos
0,35 a 0,70 1 Positivos, mínimos
0,70 a 3,5 2 Positivos, bajos a intermedios
3,5 a 17,5 3 Positivos, intermedios a altos
17,5 a 50 4 Positivos, altos
50 a 100 5 Positivos, muy altos
Más de 100 6 Positivos, al máximo

Los límites entre una clase y otra no se deben interpretar con rigidez, puesto que los análisis no tienen exactitud matemática y los niveles pueden variar ligeramente de unos días a otros. Habitualmente los aparatos de análisis no diferencian si los niveles de más de 100 están en 101, en 200, en 500 ó más. Si se quiere afinar, habría que repetir los análisis haciendo diluciones de la sangre.
Los niveles de menos de 0,35 se interpretan como normales, aunque esto está últimamente en revisión, pues parece que niveles algo más bajo también pueden corresponder a alergia.
¿Coinciden la IgE total alta y la IgE específica alta?
No siempre. Hay personas con IgE total normal, es decir, no tienen mucha predisposición general, pero sin embargo tienen IgE específica alta o incluso muy alta contra una sustancia determinada, se han sensibilizado frente a ese alergeno. Del mismo modo, algunas personas con IgE total alta, con facilidad para hacerse alérgicas, puede ser que no tengan IgE específica contra ningún alergeno concreto, no se han sensibilizado frente a nada. Con el paso del tiempo pueden acabar haciéndose alérgicos a uno o varios alergenos, pero también puede que nunca desarrollen alergia.
¿Niveles altos de IgE específica quiere decir alergia intensa?
En general coinciden los niveles altos con síntomas más intensos. Pero, igual que con las pruebas de piel, hay muchas excepciones. Puede haber pacientes con niveles relativamente bajos y síntomas intensos, y viceversa, pacientes con niveles relativamente altos y con síntomas leves e incluso sin nada de síntomas. Los pacientes con niveles muy altos es casi seguro que tengan síntomas.
¿Coinciden los resultados de las pruebas de piel y de los análisis?
En general coinciden, pero no siempre. Tanto las pruebas de piel como los análisis se usan para ver si una persona tiene IgE frente a un alergeno. Pero los análisis miden si hay IgE circulando por la sangre, y las pruebas si hay IgE en la piel. Algunas personas pueden tener pruebas positivas y análisis negativos, o viceversa. El hecho de que se encuentre IgE en cualquiera de los dos sitios quiere decir que el paciente está sensibilizado.

¿Son más fiables las pruebas o los análisis?
No son más fiables unas que otros. Dan información distinta y se complementan los resultados. El especialista puede hacer sólo pruebas, o sólo análisis, o ambas cosas según los datos del historial de cada paciente individual.

¿Tener IgE específica quiere decir tener alergia?
No siempre. Se puede detectar si una persona tiene IgE mediante pruebas o análisis. Si se obtienen resultados positivos se dice que esa persona está sensibilizada. Entre las personas sensibilizadas, algunas tienen síntomas causados por el alergeno sensibilizante, y entonces decimos que son alérgicas. Otras personas no tienen síntomas y decimos que están simplemente sensibilizadas, pero no son alérgicas.

25 comentarios sobre “¿Qué análisis se realizan en Sangre para diagnosticar la alergia?

  1. María Teresa Aznar dice:

    Buenas tardes.El año pasado me hice un análisis de sangre por indicación médica para detectar si era alérgica.Según el resultado me dijeron que no.Yo tengo 56 años, y hace 4 años que comencé desde el mes de abril y hasta fines de septiembre y parte de octubre, con ardor en la garganta, faringe y a veces picazón en el paladar y en los labios.Los días de humedad y frío se agudiza y suelo tener secreciones acuosas en la garganta y la nariz húmeda.Por momentos tengo la voz ronca y me duele la garganta.El otorrino descartó un escurrimiento nasofaríngeo.Puede ser que sea alérgica, a pesar de no haber sido detectado en el análisis de sangre? Qué debo hacer? Muchas gracias!

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