Does a positive mould IgE result mean the patient is clinically allergic?

Not necessarily. Sensitisation — measurable IgE — is common and often asymptomatic. Clinical allergy requires both positive IgE and symptoms that correlate with exposure, so results must be interpreted alongside history and symptom patterns.

When should practitioners suspect allergic bronchopulmonary aspergillosis?

Consider ABPA in asthma or cystic fibrosis patients with recurrent pulmonary infiltrates, bronchiectasis, elevated eosinophils, and total IgE >1000 kU/L. Aspergillus-specific IgE >0.35 kU/L, ideally >0.70 kU/L, is a diagnostic criterion when interpreted with imaging and other serology.

Can patients take antihistamines before this test?

Yes. Unlike skin-prick testing, serum IgE measurement is not affected by antihistamines or most allergy medications, so patients can continue their usual therapy before the blood draw.

What does it mean if total IgE is very high but specific IgE results are low?

Markedly elevated total IgE with low specific IgE to the tested moulds suggests either sensitisation to allergens not included in the panel, parasitic infection, or a non-allergic cause of IgE elevation. Correlation with travel history, eosinophil count, and additional allergen testing can clarify the picture.

How does this panel inform allergen immunotherapy decisions?

Positive specific IgE identifies the moulds to which a patient is sensitised, guiding the selection of allergens for inclusion in sublingual or subcutaneous immunotherapy. Immunotherapy is most effective when targeted to confirmed sensitisations that correlate with symptoms.

Why are Alternaria and Aspergillus particularly important in this panel?

Alternaria sensitisation is strongly associated with severe asthma and asthma exacerbations, especially in children, while Aspergillus sensitisation is the serological hallmark of allergic bronchopulmonary aspergillosis. Both carry greater clinical weight than Cladosporium or Penicillium in risk stratification.

What environmental interventions follow a positive mould allergy result?

Confirmed mould sensitisation warrants assessment for water damage, high indoor humidity, and visible mould growth. Remediation of leaks, use of dehumidifiers to maintain humidity below 50 per cent, and HEPA filtration reduce spore exposure. Outdoor mould avoidance during peak seasons is also advised.

BML-ENV-004environmental mouldUSA

Allergy-Mold Profile plus IgE

Q: What is the difference between specific IgE and total IgE in this panel?

Specific IgE measures antibodies directed against individual mould allergens and confirms sensitisation to Alternaria, Aspergillus, Cladosporium, or Penicillium. Total IgE is the sum of all circulating IgE and contextualises atopic status; very high total IgE alongside elevated Aspergillus-specific IgE supports a diagnosis of allergic bronchopulmonary aspergillosis.

The Allergy-Mold Profile plus IgE measures serum-specific IgE to Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, and Penicillium notatum, plus total IgE, to identify mould sensitisation in allergic rhinitis, asthma, and suspected allergic bronchopulmonary aspergillosis.

Biomarkers

Blood (serum)

Sample

3–5 business days

Turnaround

Fasting

What is the Mold Profile IgE test?

The Allergy-Mold Profile plus IgE measures serum-specific IgE antibodies to four common allergenic moulds — Alternaria alternata, Aspergillus fumigatus, Cladosporium herbarum, and Penicillium notatum — alongside total IgE to contextualise atopic status. Practitioners order this panel to investigate respiratory allergy and asthma suspected to be triggered or exacerbated by mould exposure, to stratify patients for targeted environmental control or allergen immunotherapy, and to screen for allergic bronchopulmonary aspergillosis when Aspergillus sensitisation is suspected. Mould allergy is a common driver of perennial allergic rhinitis and asthma and is notoriously underrecognised because symptoms overlap with other aeroallergens and because mould exposure varies with season, geography, and indoor environment quality. This profile captures the most clinically relevant fungal allergens in a single draw, enabling efficient triage and informed management decisions without requiring serial skin-prick testing.

What does the Mold Profile IgE test measure?

Alternaria IgE(Alternaria alternata-specific IgE)

Range: <0.35 kU/L is considered negative; ≥0.35 kU/L is positive, with graded severity classes to >100 kU/L.Optimal: Undetectable (<0.10 kU/L) reflects no measurable sensitisation. Values ≥0.35 kU/L confirm sensitisation; higher levels correlate with greater symptom severity and risk of exacerbations.kU/L / IU/mL

Alternaria alternata is a ubiquitous outdoor dematiaceous fungus that releases spores prolifically in warm, dry weather. Its allergens are potent triggers of type I hypersensitivity; exposure occurs through inhalation of airborne spores. IgE antibodies to Alternaria bind mast cells and basophils, and upon re-exposure the allergen crosslinks IgE, causing degranulation and release of histamine, leukotrienes, and cytokines that drive acute allergic inflammation.

Alternaria sensitisation is strongly associated with severe allergic asthma, particularly in children and adolescents, and is a risk factor for asthma exacerbations and hospital admissions. Detecting specific IgE confirms sensitisation and guides avoidance strategies and immunotherapy candidacy.

Aspergillus IgE(Aspergillus fumigatus-specific IgE)

Range: <0.35 kU/L is negative; ≥0.35 kU/L is positive, with graded severity classes.Optimal: Undetectable (<0.10 kU/L) indicates no sensitisation. Levels ≥0.35 kU/L confirm sensitisation; markedly elevated values raise suspicion for ABPA in the appropriate clinical context.kU/L / IU/mL

Aspergillus fumigatus is a thermotolerant saprophytic mould found in soil, compost, and decaying organic matter. Its small spores are inhaled readily and can colonise airways or provoke IgE-mediated hypersensitivity. Sensitisation ranges from allergic rhinitis and asthma to allergic bronchopulmonary aspergillosis in susceptible individuals.

Aspergillus-specific IgE is the serological hallmark of allergic bronchopulmonary aspergillosis (ABPA) when elevated and interpreted alongside total IgE, eosinophilia, and radiological findings. It also identifies Type I sensitisation in allergic rhinitis and asthma triggered by Aspergillus exposure.

Cladosporium IgE(Cladosporium herbarum-specific IgE)

Range: <0.35 kU/L is negative; ≥0.35 kU/L is positive, with graded classes.Optimal: Undetectable (<0.10 kU/L) is ideal. Values ≥0.35 kU/L confirm sensitisation and suggest a need for environmental assessment and avoidance.kU/L / IU/mL

Cladosporium herbarum is one of the most common airborne moulds worldwide, thriving on plant material and in indoor environments. Its spores are released year-round with seasonal peaks in temperate climates. IgE-mediated allergy to Cladosporium contributes to allergic rhinitis and asthma, though it is generally less allergenic than Alternaria or Aspergillus.

Cladosporium sensitisation is frequent in mould-allergic patients and may explain persistent perennial symptoms or seasonal exacerbations. Identifying specific IgE informs environmental control measures and allergen immunotherapy panel selection.

Penicillium IgE(Penicillium notatum-specific IgE)

Range: <0.35 kU/L is negative; ≥0.35 kU/L is positive, with graded classes.Optimal: Undetectable (<0.10 kU/L) is optimal. Values ≥0.35 kU/L confirm sensitisation and warrant environmental investigation.kU/L / IU/mL

Penicillium species, including Penicillium notatum (now Penicillium chrysogenum), are widespread indoor and outdoor moulds found in soil, food spoilage, and damp indoor environments. Spores become airborne and can provoke IgE-mediated allergic reactions in sensitised individuals, contributing to perennial allergic rhinitis and asthma.

Penicillium sensitisation is a marker of indoor mould exposure and may indicate water damage or chronic dampness in the home or workplace. Detection guides remediation efforts and informs the selection of allergen immunotherapy.

Total IgE(Total immunoglobulin E)

Range: Age-dependent; adults typically <100–150 kU/L, though reference limits vary.Optimal: Lower levels (<50 kU/L in adults) are associated with reduced atopic disease burden. Moderate elevations (150–500 kU/L) suggest significant atopy; very high values (>1000 kU/L) raise suspicion for ABPA or parasitic infection.kU/L / IU/mL

Total IgE represents the sum of all circulating IgE antibodies, both specific and non-specific. It is synthesised by B cells in response to allergen exposure, parasitic infection, and certain immunological disorders. Total IgE provides context for interpreting specific IgE results and is a biomarker of atopic status and allergic disease burden.

Elevated total IgE supports a diagnosis of atopy and helps stratify severity in allergic asthma and allergic bronchopulmonary aspergillosis. It is also elevated in helminthic infections and rare immunodeficiencies. Total IgE alone does not identify specific allergens but complements specific IgE panels.

Why is the Mold Profile IgE test ordered?

Patients with perennial or seasonal allergic rhinitis unresponsive to conventional allergen avoidance and therapy, particularly if they report symptom exacerbations in damp or mouldy environments
Children and adults with allergic asthma — especially severe, poorly controlled, or exacerbation-prone asthma — where mould sensitisation is a known risk factor for hospitalisations and treatment escalation
Investigation of suspected allergic bronchopulmonary aspergillosis in asthma or cystic fibrosis patients with recurrent infiltrates, elevated eosinophils, or bronchiectasis, where Aspergillus-specific and total IgE are diagnostic criteria
Patients with chronic rhinosinusitis or nasal polyposis refractory to medical management, in whom mould sensitisation may influence prognosis and surgical planning
Pre-assessment for allergen-specific immunotherapy to confirm sensitisation to fungal allergens and guide allergen selection for sublingual or subcutaneous protocols
Occupational or environmental evaluation of workers or residents exposed to water-damaged buildings, agricultural settings, or compost facilities where mould spore counts are high
Differential diagnosis of chronic respiratory symptoms in immunocompromised or atopic individuals where infectious and allergic fungal disease overlap
Follow-up monitoring after environmental remediation or initiation of immunotherapy to document changes in sensitisation or symptom burden over time

Sample collection and turnaround

Sample type

Blood (serum)

Fasting required

Collection method

Venipuncture at patient service centre

Turnaround

3–5 business days

Collection notes

Phlebotomy via Quest patient service centre. No special preparation required. Unlike skin-prick testing, antihistamines and most allergy medications do not interfere with serum IgE measurement and need not be discontinued before the draw.

Specimen requirements

Minimum 1.0 mL serum in a gel separator tube. Separate from cells promptly and refrigerate if not processed immediately. Stable refrigerated for up to one week; freeze for longer storage.

What can affect Mold Profile IgE results?

variableRecent antihistamine or corticosteroid use

These medications do not interfere with serum IgE measurement, unlike skin-prick testing, so testing can proceed without medication washout.

reducesAcute systemic corticosteroid therapy or immunosuppression

Chronic high-dose corticosteroids or biologics targeting IgE (omalizumab) may suppress total and specific IgE synthesis, potentially yielding false-negative or attenuated results.

elevatesRecent or concurrent parasitic infection

Helminthic infections stimulate polyclonal IgE production, markedly raising total IgE and potentially confounding interpretation of atopic status; specific IgE remains valid for allergen identification.

variableAge and atopic background

Total IgE reference ranges are age-dependent and higher in atopic individuals; sensitisation prevalence and titre also vary with age, geography, and exposure history.

variableCross-reactivity between fungal allergens

Some mould allergens share epitopes, so sensitisation to one species may yield low-level reactivity to another; clinical correlation and exposure history are essential to distinguish true polysensitisation from cross-reactivity.

elevatesSeasonal and environmental spore exposure

Specific IgE titres can rise during or shortly after peak exposure seasons or following occupancy of mould-contaminated environments, so timing of testing relative to exposure affects interpretation.

What do Mold Profile IgE results mean?

Elevated

Specific IgE ≥0.35 kU/L to any of the four moulds confirms sensitisation and implicates that allergen as a contributor to respiratory symptoms. Alternaria sensitisation is associated with severe asthma and exacerbations. Aspergillus-specific IgE ≥0.35 kU/L, particularly when markedly elevated (>0.70 kU/L) alongside total IgE >1000 kU/L, eosinophilia, and compatible imaging, meets diagnostic criteria for allergic bronchopulmonary aspergillosis. Cladosporium and Penicillium sensitisation indicates perennial mould allergy and warrants environmental assessment for indoor dampness and water damage. Total IgE >100–150 kU/L confirms atopy and supports the clinical diagnosis of IgE-mediated allergy; very high total IgE (>1000 kU/L) raises suspicion for ABPA or parasitic infection.

Normal

Specific IgE in the equivocal range (0.10–0.34 kU/L) may reflect low-level sensitisation not yet clinically relevant, recent early sensitisation, or assay variability; correlation with symptoms and repeat testing after sustained exposure can clarify significance. Total IgE within the age-adjusted reference range is consistent with either non-atopic status or well-controlled atopy, depending on clinical context.

Reduced

Specific IgE <0.10 kU/L to all tested moulds makes IgE-mediated mould allergy unlikely as a cause of symptoms. Low total IgE (<50 kU/L) suggests a non-atopic phenotype and reduces the likelihood of IgE-driven allergic disease, prompting consideration of non-allergic rhinitis, intrinsic asthma, or other aetiologies.

Note: Sensitisation (positive IgE) does not equal clinical allergy — asymptomatic sensitisation is common, so results must be interpreted alongside exposure history and symptom pattern. Negative specific IgE does not exclude mould-triggered symptoms if non-IgE mechanisms (irritant, toxic, or innate immune pathways) are operative. The panel covers four common allergenic moulds but does not represent the full spectrum of fungal exposures; additional allergens may be tested if suspicion persists. Aspergillus IgE should be interpreted with total IgE, eosinophil count, and imaging when ABPA is suspected.

Frequently asked questions

Specific IgE measures antibodies directed against individual mould allergens and confirms sensitisation to Alternaria, Aspergillus, Cladosporium, or Penicillium. Total IgE is the sum of all circulating IgE and contextualises atopic status; very high total IgE alongside elevated Aspergillus-specific IgE supports a diagnosis of allergic bronchopulmonary aspergillosis.

How to access the Mold Profile IgE test

The Mold Profile IgE reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.

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About this page

Published: October 7, 2026

Last reviewed: October 7, 2026

References:

Agarwal R, et al. Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification criteria. Clin Exp Allergy. (2013)
Sharpe RA, et al. Higher energy efficient homes are associated with increased risk of doctor diagnosed asthma in a UK subpopulation. Environ Int. (2015)
Denning DW, et al. The link between fungi and severe asthma: a summary of the evidence. Eur Respir J. (2006)
Roberts G, et al. EAACI guidelines on allergen immunotherapy: allergic rhinoconjunctivitis. Allergy. (2018)
Black PN, Udy AA, Brodie SM. Sensitivity to fungal allergens is a risk factor for life-threatening asthma. Allergy. (2000)

This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.