Allergy Testing Today: What Labs Need to Know About Accuracy, Interference & Innovation

Accurate allergy testing is one of the most vital components of modern diagnostics — yet it’s often one of the most misunderstood.

Many labs still use legacy systems for IgE testing that have been around for decades, designed for older clinical demands. While these systems may still function, they often carry silent weaknesses: hidden interferences, high sample requirements, or inefficient workflows that make consistent performance difficult to maintain.

In an era where diagnostic clarity is everything, that’s a problem worth addressing.

Understanding the Limits of Traditional Allergy Testing Systems

Let’s break down the four most common limitations affecting allergy diagnostics in today’s labs — especially those using conventional platforms like ELISA or cellulose-based systems.

1. High Sample Volume Requirements

Most traditional systems require between 50–100 µL of serum per allergen. That may not sound like much — but in practice, this can create serious limitations:

  • In pediatric or geriatric patients, blood volume is limited.

  • Running large allergen panels requires multiple tubes or sacrifice of test depth.

  • Repeat testing due to technical errors becomes more difficult.

Labs that rely on these platforms often face constraints in flexibility and patient comfort.

2. CCD Interference and False Positives

Cross-reactive carbohydrate determinants (CCDs) are sugar chains present in many plants, insects, and other organisms. In allergy diagnostics, they pose a known problem: they can bind to IgE antibodies and generate false-positive results — especially in systems that use cellulose as a solid phase.

This doesn’t just skew the results — it can lead to:

  • Misdiagnosis of allergies that aren't clinically relevant.

  • Overly restrictive diets (especially in food panels).

  • Frustration from both clinicians and patients.

CCD interference is one of the most cited reasons for follow-up testing, increasing cost and diagnostic uncertainty.

3. Biotin Interference

Biotin (Vitamin B7) is commonly taken as a supplement — often in high doses for hair, skin, or nail health. But in some immunoassays, biotin can interfere with the biotin-streptavidin reaction and cause falsely low results.

In allergy testing, this can result in:

  • Missed allergens (false negatives).

  • Inaccurate IgE levels.

  • Potential exposure to allergens the patient should be avoiding.

This risk is especially relevant as more consumers self-supplement with high-dose biotin, often without informing clinicians.

4. Manual or Batch-Based Workflows

Older systems often rely on batch processing — requiring full sample racks to be loaded before a run can start. These workflows introduce:

  • Delays in result turnaround.

  • Higher labor demand due to hands-on steps.

  • Rigid test ordering that’s hard to scale on-demand.

In the context of modern labs managing growing test volumes and rising staffing pressures, these inefficiencies add up.

What Should a Modern Allergy Testing Platform Look Like?

The best solutions are designed from the ground up to address these real-world challenges. A next-gen allergy diagnostic platform should offer:

  • Low Sample Volume Requirements — ideally <10 µL per allergen
  • No CCD or biotin interference, ensuring clinical relevance of results
  • Automated, continuous loading — not restricted to batches
  • Reproducible performance — regardless of operator or time of day
  • Smaller footprint — saving bench space and resources
  • Digital integration — for seamless LIS connectivity

These aren’t aspirational — they’re fast becoming the benchmark for IgE testing in clinical immunology labs around the world.

Looking Ahead: Allergy Testing That Keeps Up With Clinical Expectations

As allergy prevalence continues to rise globally, labs need systems that are reliable, reproducible, and built for modern-day challenges. That means fewer redraws, fewer false positives, and results clinicians can trust without hesitation.

If you're looking to upgrade or expand your lab’s allergy testing capabilities, you can explore our full range of allergy diagnostic solutions here.