Food allergy: When and how to perform oral food challenges

@article{Sicherer1999FoodAW,
  title={Food allergy: When and how to perform oral food challenges},
  author={S. Sicherer},
  journal={Pediatric Allergy and Immunology},
  year={1999},
  volume={10}
}
  • S. Sicherer
  • Published 1999
  • Medicine
  • Pediatric Allergy and Immunology
In many situations, the diagnosis of food allergy rests simply upon a history of an acute onset of typical symptoms, such as hives and wheezing, following the isolated ingestion of a suspected food, with confirmatory laboratory studies of positive prick skin tests or RASTs. However, the diagnosis is more complicated when multiple foods are implicated or when chronic diseases, such as asthma or atopic dermatitis, are evaluated. The diagnosis of food allergy and identification of the particular… Expand
Diagnosis of Food Allergy in Children: Toward a Standardization of Food Challenge
TLDR
This review presents the current status of the indication and performance of controlled oral food challenges in children with suspected food-related symptoms and discusses aspects of indications and contraindications, blinding, diet before the challenge, the practical performance, the handling of medication, the interpretation of test results, suitable locations for testing, safety considerations, and the procedure after a period of avoidance. Expand
Tests for Immunological Reactions to Foods
TLDR
Some of the tests discussed in this chapter not only aid in the diagnosis of food allergies, but also are useful in monitoring the natural history of patients' food allergies over time, from diagnosis to oral tolerance. Expand
Food Allergy: Diagnosis of Food Allergy
TLDR
The most definitive test available to determine an adverse reaction to food is the physician-supervised oral food challenge (OFC), but ancillary tests are used to determine if a food allergy is likely and additional tests that are emerging with regard to their diagnostic value are shown. Expand
Controlled oral food challenges in children – when indicated, when superfluous?
TLDR
The current knowledge of predictors for the outcome of oral food challenges is reviewed and proposals for the daily practical work‐up in the case of suspected food related clinical symptoms are presented. Expand
Food allergy in children
TLDR
The medical care of a food allergic child requires concurrent dietary advice and management, risk avoidance and emergency management plans, and reintroduction of foods occurs when the risk profile is appropriate based mainly on the predictive information obtained by SPTs and specific IgE levels. Expand
Food allergy in children.
TLDR
The medical care of a food allergic child requires concurrent dietary advice and management, risk avoidance and emergency management plans, and reintroduction of foods occurs when the risk profile is appropriate based mainly on the predictive information obtained by SPTs and specific IgE levels. Expand
Oral Food Challenges in Children: Review and Future Perspectives
TLDR
The magnitude of the serum and skin tests may be of assistance in stratifying a patient’s risk of passing a challenge, and newer diagnostic tests may help better stratify such risk of based on particular epitope recognition. Expand
Food allergies: detection and management.
TLDR
Patients with anaphylactic reactions need emergent epinephrine and instruction in self-administration in the event of inadvertent exposure, and Antihistamines can be used for more minor reactions. Expand
Diagnostic pitfalls in food allergy in children
TLDR
There are several pitfalls in the diagnostic work‐up of food allergy, which may be misleading for the physician, as well as the problem of non‐IgE‐mediated reactions. Expand
Beyond oral food challenges: improved modalities to diagnose food hypersensitivity disorders.
  • S. Sicherer
  • Medicine
  • Current opinion in allergy and clinical immunology
  • 2003
TLDR
The atopy patch test (APT), in which foods are applied to the skin under Finn chambers in a manner similar to that used with classic contact allergens in patch testing, has been investigated to address limitations, but this methodology is also limited by relatively low positive predictive accuracy. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 51 REFERENCES
Prevalence of IgE-Mediated Food Allergy Among Children With Atopic Dermatitis
TLDR
Approximately one third of children with refractory, moderate–severe AD have IgE-mediated clinical reactivity to food proteins, and an evaluation for food allergy should be considered in these patients. Expand
ADVERSE REACTIONS TO FOOD
TLDR
The treatment of food-induced urticaria consists of elimination the offending food or substance from the diet, use of antihistamines and immunotherapy, and the gold standard in diagnosis is double blind placebo-controlled food test. Expand
Natural history of food hypersensitivity in children with atopic dermatitis.
Patients with atopic dermatitis and food hypersensitivity who were adhering to an elimination diet underwent repeat double-blind, placebo-controlled oral food challenges annually for follow-up ofExpand
THE ROLE OF FOOD ALLERGY IN CHILDHOOD ASTHMA
TLDR
The diagnosis of food-induced asthma and the subsequent identification and elimination of causative foods requires a careful history, laboratory evaluation and, in many cases, confirmation by challenge testing. Expand
Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents.
TLDR
By measuring the concentrations of food-specific IgE antibodies with the CAP System FEIA, it is possible to identify a subset of patients who are highly likely to experience clinical reactions to egg, milk, peanut, or fish and eliminate the need to perform DBPCFCs. Expand
Food allergy. Part 1: immunopathogenesis and clinical disorders.
  • H. Sampson
  • Medicine
  • The Journal of allergy and clinical immunology
  • 1999
TLDR
In part 1 of this series, immunopathogenic mechanisms and clinical disorders of food allergy are described. Expand
Food hypersensitivity in children: Clinical aspects and distribution of allergens
TLDR
The aims of this work were to investigate the clinical aspects of food hypersensitivity and the distribution of allergens, in children and adolescents, in a prospective and descriptive study, and to identify five allergens responsible for more than three‐quarters of food allergies in children. Expand
Atopic dermatitis and food hypersensitivity reactions.
TLDR
This study confirms that most children with atopic dermatitis have food allergy that can be diagnosed by a prick skin test for the seven foods, and screening prick skin tests for these seven foods identified 99% of the food allergic patients correctly. Expand
Allergenic cross-reactivity of foods and characterization of food allergens and extracts.
  • J. Bernhisel-Broadbent
  • Medicine
  • Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 1995
TLDR
The further identification of major allergenic components of food and the identification of specific IgE antibodies to these allergens should make the clinical approach to the treatment, understanding, and diagnosis of food hypersensitivity easier. Expand
Interpreting skin prick tests in the evaluation of food allergy in children
  • P. Eigenmann, H. Sampson
  • Medicine
  • Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology
  • 1998
TLDR
Skin prick tests are a useful procedure for evaluating clinical reactivity to egg, milk, peanut and wheat, but not to soy, and the predictive values were no better than the commonly utilized grading method. Expand
...
1
2
3
4
5
...