The optimal diagnostic workup for children with suspected food allergy


Food allergy is an abnormal immune system reaction to food proteins, but as well as causing anaphylaxis and allergic reactions, there are an increasing number of cell-mediated disorders like Eosinophilic Esophagitis (EE) and enterocolitis syndrome.

More than 90% of childhood allergies are caused by eight foods: shellfish, cow’s milk, hen’s egg, soy, peanuts, treenuts, wheat and fish. The diagnostic work up for children with suspected food allergy includes a detailed medical history, physical examination, food allergy screening tests, responses to an elimination diet and an oral food challenge. No screening test alone or in combination can determine the presence or absence of food allergy. New methods that look at the immune system response or epitopes of specific proteins are in progress, and unconventional methods lack scientific rationale, standardisation or reproducibility. In some cases, EE gastroenteropathies and gastroesophageal reflux disease, invasive procedures must be done in order for an accurate diagnosis to be made. A correctly supervised and carried out food challenge is still the gold standard in the diagnostic work up – if an allergy is misdiagnosed the child risks unnecessary dietary restrictions which may adversely affect the child’s nutritional status and growth.

Source: PubMed

Also see Allergy Research Foundation conference report - Component Testing.

First published in October 2011

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