From the Guidelines
Food allergy should be suspected in individuals presenting with anaphylaxis or any combination of symptoms that occur within minutes to hours of ingesting food, especially in young children and/or if symptoms have followed the ingestion of a specific food on more than 1 occasion. When considering a food allergy profile, it is essential to understand that this test measures IgE antibodies to specific foods, helping identify potential food allergies 1. I recommend getting this test if you experience symptoms like hives, swelling, digestive issues, or breathing problems after eating certain foods. The test requires a simple blood draw and typically screens for common allergens including peanuts, tree nuts, milk, eggs, wheat, soy, fish, and shellfish. Results usually take 3-7 days and are reported as classes (0-6) or numerical values, with higher numbers indicating stronger allergic sensitivity. However, these tests should be interpreted by an allergist alongside your clinical history, as positive results don't always mean clinical allergy. False positives and negatives can occur, so follow-up testing like skin prick tests or oral food challenges may be needed for confirmation. Some key points to consider when managing food allergies include:
- The prevalence of childhood food allergy in the United States is approximately 8% and has increased during the past decade 1.
- The most common food allergens are milk, egg, wheat, soy, peanut, tree nut, finfish, and shellfish 1.
- Food allergy diagnosis requires documentation of a clinical history of a food allergic reaction 1.
- All food-allergic patients should be prescribed antihistamines (mild reactions) and an epinephrine autoinjector device (severe reactions) 1. Food allergy profiles are particularly useful for patients with severe reactions, multiple suspected allergies, or when skin testing isn't feasible, but they should be part of a comprehensive allergy evaluation rather than used in isolation. It is also crucial to provide comprehensive counseling regarding food allergy, including food avoidance and appropriate nutritional monitoring, label reading, recognition of the signs and symptoms of anaphylaxis, and how and when to use the epinephrine autoinjector 1. Current research focuses on finding a treatment for food allergy, with several potential therapeutic modalities being investigated, including oral immunotherapy, sublingual immunotherapy, and Chinese herbal medicine 1. Overall, a food allergy profile can be a valuable tool in identifying potential food allergies, but it should be used in conjunction with clinical history and other diagnostic tests to ensure accurate diagnosis and effective management.
From the Research
Food Allergy Profile
- Food allergy is a growing concern, and recognition of symptoms, knowledge of common food allergens, and management of reactions are important for patients and practitioners 2.
- Symptoms of a classic IgE-mediated food allergy vary in severity and can include any combination of laryngeal edema, wheezing, nausea, vomiting, diarrhea, urticaria, angioedema, and hypotension 2.
- The most commonly implicated foods include:
- Cow's milk
- Egg
- Peanut
- Tree nut
- Soy
- Wheat
- Fish
- Shellfish 2
Diagnosis of Food Allergy
- Diagnosis of food allergy includes:
- Skin prick tests are restricted to IgE-mediated food allergies and results indicate sensitization to a certain food, but do not necessarily suggest food allergy 4.
- The risk of systemic reactions to skin prick-tests is low, estimated to be around 0.008% to 0.02% 5, 6.
Management of Food Allergy
- Management is centered on avoidance of allergenic and cross-reacting foods and early recognition and immediate treatment of reactions 2.
- Treatment protocols to desensitize patients to food are currently under investigation 2.
- It is essential to recognize the potential for cross-reactivity among food groups and to take necessary precautions, especially in patients with a history of atopy or previous systemic reactions 2, 6.