The Contribution of Molecular Allergology to the Diagnosis of Allergies: A Report of Cases Series

Abstract

Background: Component resolved Diagnosis (CRD) is an essential tool in modern allergology, allowing a more precise and personalized approach. Case Presentation: We report five patients with suspected allergy investigated using component-resolved diagnostics by the ALEX biochip. Case 1: A 31-year-old man presented with recurrent episodes of urticaria. Subsequently, the patient developed respiratory manifestations. Molecular diagnostic testing revealed sensitization to the component Pru p 3, consistent with lipid transfer protein (LTP) allergy, which allowed for an accurate diagnosis and guided appropriate avoidance measures. Case 2: A young woman experienced exercise-induced anaphylaxis after ingestion of wheat-containing food. Conventional testing was inconclusive, but molecular analysis revealed sensitization to ω5-gliadin, confirming wheat-dependent exercise-induced anaphylaxis. Case 3: A 42-year-old woman presented with generalized urticaria and pruritus, particularly following the ingestion of seafood. Molecular diagnostic testing revealed sensitization to tropomyosin and enabled assessment of the risk of severe reactions, which correlated with specific IgE levels to shrimp tropomyosin. Case 4: A 28-year-old man presented with perennial rhinitis and atopic dermatitis. Immunoallergological evaluation revealed concomitant sensitization to serum albumins, particularly Fel d 2 and Sus d 1, suggesting cross-reactivity consistent with pork–cat syndrome. Case 5: A 40-year-old woman with birch pollen allergy developed oral allergy syndrome after ingesting food. Molecular testing identified sensitization to PR-10 proteins, confirming pollen–food syndrome and allowing targeted dietary advice. Conclusion: CRD must be integrated into the allergological exploration in order to optimize management.