Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 25 1 2026 01 01 16 23 EN Maedeh Khoshkam Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahshid Movahedi Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Gharagozlou Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Monir Farokhzadeh Soltani Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoud Movahedi Division of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran 2025 04 12 2025 06 23 Component- Resolved Diagnosis (CRD) is an effective tool in allergy diagnosis, that detects specific IgE to allergenic molecules. The ALEX (Allergy Explorer) test, commercially available since 2019, measures specific IgE to allergenic extracts and components associated with inhalant, food, animal, latex, and insect allergens. CRD results should be interpreted based on the patient's clinical history. Since Children's Medical Center Hospital is one of the largest referral centers for allergic patients, we evaluated the results of the ALEX2 test in patients referred to this center and compared them with the patients’ clinical symptoms. Clinical symptoms were concordant with positive CRD (ALEX2) test in 76.7% of cases. The overall agreement between positive allergen components and clinical symptoms was 58%. These findings indicate that the ALEX2 test can improve diagnostic accuracy in allergic patients; however, positive test results should be interpreted in the context of the patient’s clinical history. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4327 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4327/2230