The Diagnosis of Food Allergy
- 1 November 2010
- journal article
- case report
- Published by SAGE Publications in American Journal of Rhinology and Allergy
- Vol. 24 (6), 439-443
- https://doi.org/10.2500/ajra.2010.24.3515
Abstract
Background Food allergy is increasingly common; however, there is a discrepancy between the large number of people who believe they or their children are affected and the actual number with true food allergies. It is therefore imperative that physicians evaluating patients with possible adverse reactions to foods understand the current modalities used to diagnose food allergies. Methods Simple tests including skin-prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests have pitfalls and their usefulness must be appreciated to avoid over- and underdiagnosis. Results A firm diagnosis is imperative because a misdiagnosis could lead to life-threatening reactions and overdiagnosis will lead to unnecessary elimination diets with nutritional and social implications. Physician-supervised oral food challenges (OFC) remain the gold standard for food allergy diagnosis; however, a careful medical history and simple tests can often provide a reliable diagnosis. Conclusion In this review, we examine the usefulness and pitfalls of SPT used by allergists and serum food-specific IgE levels that are available to all practitioners. We also review the OFC as a diagnostic modality in food allergy. Finally, we describe emerging tests, such as the basophil activation test, atopy patch testing, and component-resolved diagnostics, that may be of benefit in the future.Keywords
This publication has 54 references indexed in Scilit:
- Food allergyJournal of Allergy and Clinical Immunology, 2009
- Food Allergy Among Children in the United StatesPublished by American Academy of Pediatrics (AAP) ,2009
- Nutritional problems related to food allergy in childhoodPediatric Allergy and Immunology, 2008
- The prevalence of food allergy: A meta-analysisJournal of Allergy and Clinical Immunology, 2007
- Food allergy – accurately identifying clinical reactivityAllergy, 2005
- Comparative study of commercial food antigen extracts for the diagnosis of food hypersensitivityJournal of Allergy and Clinical Immunology, 1988
- Atopic dermatitis: Clinical relevance of food hypersensitivity reactionsThe Journal of Pediatrics, 1988
- Evaluation of immediate adverse reactions to foods in adult patients: I. Correlation of demographic, laboratory, and prick skin test data with response to controlled oral food challengeJournal of Allergy and Clinical Immunology, 1985
- Comparison of results of skin tests, RAST, and double-blind, placebo-controlled food challenges in children with atopic dermatitisJournal of Allergy and Clinical Immunology, 1984
- Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic childrenJournal of Allergy and Clinical Immunology, 1976