Oral food challenges in clinical practice: a missing element of food allergy diagnosis in Russia

2021 ◽  
Vol 17 (4) ◽  
pp. 19-29
Author(s):  
Daria M. Levina ◽  
Ilya A. Korsunskiy ◽  
Daniel B. Munblit
Keyword(s):  
Food Allergy ◽  
Russian Federation ◽  
Food Challenge ◽  
Clinical History ◽  
Allergy Diagnosis ◽  
Laboratory Test Results ◽  
The World ◽  
Life Threatening ◽  
Food Challenges ◽  
Food Allergy Diagnosis

Food allergy is one of the most prevalent allergic conditions, causing reduction in patient quality of life. It is linked with high levels of anxiety due to potential life-threatening reactions, and high economic burden for a healthcare system. Food allergy affects approximately 5 to 10% of children around the world. In Russian Federation the diagnosis of food allergy is primarily based on clinical history, laboratory test results, examination and elimination of suspected food. Meanwhile oral food challenge (OFC) is considered a gold standard of food allergy diagnosis by most of professional bodies nationally and internationally. OFC is a diagnostic procedure involving administration of a causative allergen in gradually increasing amount under a close medical supervision. The method is safe, highly specific and sensitive and is widely used around the world for more than 45 years. The main goals of OFC include food allergy diagnosis and presence of tolerance evaluation, which may result in diet expansion. OFC may also help establishing both, reaction severity and dose needed to elicit reaction, which may further assist with alleviation of patients anxiety. In this paper we discuss existing approaches to the diagnosis of food allergy in Russian Federation and review available recommendations on OFC outlined in international guidelines.

scholarly journals Using oral food challenges to provide clarity and confidence when diagnosing food allergies

2021 ◽  
Vol 3 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Justin Greiwe
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Food Challenge ◽  
Clinical History ◽  
The United States ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Ige Mediated ◽  
Challenge Education ◽  
Food Challenges

A verified food allergy can be an impactful life event that leads to increased anxiety and measurable effects on quality of life. Allergists play a key role in framing this discussion and can help alleviate underlying fears by promoting confidence and clarifying safety concerns. Correctly diagnosing a patient with an immunoglobulin E (IgE) mediated food allergy remains a nuanced process fraught with the potential for error and confusion. This is especially true in situations in which the clinical history is not classic, and allergists rely too heavily on food allergy testing to provide a confirmatory diagnosis. A comprehensive medical history is critical in the diagnosis of food allergy and should be used to determine subsequent testing and interpretation of the results. Oral food challenge (OFC) is a critical procedure to identify patients with an IgE-mediated food allergy when the history and testing are not specific enough to confirm the diagnosis and can be a powerful teaching tool regardless of outcome. Although the safety and feasibility of performing OFC in a busy allergy office have always been a concern, in the hands of an experienced and trained provider, OFC is a safe and reliable procedure for patients of any age. With food allergy rates increasing and analysis of recent data that suggests that allergists across the United States are not providing this resource consistently to their patients, more emphasis needs to be placed on food challenge education and hands-on experience. The demand for OFCs will only continue to increase, especially with the growing popularity of oral immunotherapy programs; therefore, it is essential that allergists become familiar with the merits and limitations of current testing modalities and open their doors to using OFCs in the office.

scholarly journals Immunoglobulin E‐mediated food allergy diagnosis and differential diagnosis

2020 ◽  
Vol 2 (1) ◽  
pp. 26-30
Author(s):  
Charles F. Schuler IV ◽  
Malika Gupta ◽  
Georgiana M. Sanders
Keyword(s):  
Differential Diagnosis ◽  
Immunoglobulin E ◽  
Food Challenge ◽  
Clinical History ◽  
Food Allergies ◽  
Duration Of Symptoms ◽  
Symptom Complex ◽  
Food Challenges ◽  
Food Allergy Diagnosis ◽  
Double Blinded

Food allergies consist of aberrant immunologic, typically immunoglobulin E mediated, reactions that involve food proteins. A clinical history with regard to the suspected food, temporal associations, the duration of symptoms, characteristic symptom complex, and reproducibility in some cases is the key to making an accurate diagnosis. The differential diagnosis includes, for example, other immunologic adverse food reactions, nonimmunologic adverse food reactions, and reactions that involve nonfood items. Skin and blood immunoglobulin E testing for the suspected food antigen can aid the diagnosis in the context of a supportive clinical history. Immunoglobulin E testing for food components may further enhance diagnostic accuracy. Novel testing modalities are under development but are not yet ready to replace the current paradigm. Thus, double-blinded placebo controlled oral food challenge is considered the criterion standard of testing, although unblinded oral food challenges are usually confirmatory.

Advances in Food Allergy Diagnosis

2018 ◽  
Vol 14 (3) ◽  
pp. 139-149 ◽  
Author(s):  
Joana Gomes-Belo ◽  
Farah Hannachi ◽  
Kate Swan ◽  
Alexandra F. Santos
Keyword(s):  
Food Allergy ◽  
Allergy Diagnosis ◽  
Food Allergy Diagnosis

scholarly journals Improved prospects for food allergy prevention

2017 ◽  
Vol 9 (4) ◽  
pp. 254 ◽  
Author(s):  
Rohan Ameratunga
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Allergy Prevention ◽  
Window Of Opportunity ◽  
Early Introduction ◽  
The World ◽  
Food Challenges ◽  
High Risk Children

ABSTRACT Three recent publications from Professor Gideon Lack have fundamentally changed our understanding of how to prevent food allergy. His team has shown that early introduction of allergenic foods may prevent food allergy in most but not all high-risk children. Various allergy and paediatric societies around the world are changing their recommendations based on these three studies. It appears there is a window of opportunity to safely introduce allergenic foods to high-risk children. This has resource implications, as some of these children will need testing and food challenges.

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