J Andrew Bird1. 1. Division of Allergy and Immunology, Department of Pediatrics, University of Texas Southwestern Medical Center, and the Food Allergy Center at Children's Medical Center, Dallas, Texas, USA.
Abstract
BACKGROUND: Diagnosing food allergy is often challenging, and validated testing modalities are mostly limited to immunoglobulin E (IgE)-mediated reactions to foods. Use of food-specific IgE tests and skin prick tests in individuals without a history that supports an IgE-mediated reaction to the specific food being tested diminishes the predictive capabilities of the test. OBJECTIVE: To review the literature regarding evaluation of patients with a concern for multiple food allergies and to demonstrate an evidence-based approach to diagnosis and management. METHODS: A literature search was performed and articles identified as relevant based on the search terms "food allergy," "food allergy diagnosis," "skin prick test," "serum IgE test," "oral food challenge", and "food allergy management." RESULTS: Patients at risk of food allergy are often misdiagnosed and appropriate evaluation of patients with concern for food allergy includes taking a thorough diet history and reaction history, performing specific tests intentionally and when indicated, and conducting an oral food challenge in a safe environment by an experienced provider when test results are inconclusive. CONCLUSION: An evidence-based approach to diagnosing and managing a patient at risk of having a life-threatening food allergy is reviewed.
BACKGROUND: Diagnosing food allergy is often challenging, and validated testing modalities are mostly limited to immunoglobulin E (IgE)-mediated reactions to foods. Use of food-specific IgE tests and skin prick tests in individuals without a history that supports an IgE-mediated reaction to the specific food being tested diminishes the predictive capabilities of the test. OBJECTIVE: To review the literature regarding evaluation of patients with a concern for multiple food allergies and to demonstrate an evidence-based approach to diagnosis and management. METHODS: A literature search was performed and articles identified as relevant based on the search terms "food allergy," "food allergy diagnosis," "skin prick test," "serum IgE test," "oral food challenge", and "food allergy management." RESULTS:Patients at risk of food allergy are often misdiagnosed and appropriate evaluation of patients with concern for food allergy includes taking a thorough diet history and reaction history, performing specific tests intentionally and when indicated, and conducting an oral food challenge in a safe environment by an experienced provider when test results are inconclusive. CONCLUSION: An evidence-based approach to diagnosing and managing a patient at risk of having a life-threatening food allergy is reviewed.
Authors: Sandra Andorf; Magnus P Borres; Whitney Block; Dana Tupa; Jennifer B Bollyky; Vanitha Sampath; Arnon Elizur; Jonas Lidholm; Joseph E Jones; Stephen J Galli; Rebecca S Chinthrajah; Kari C Nadeau Journal: J Allergy Clin Immunol Pract Date: 2017-03-27