Diagnostic evaluation of food allergy
- Wesley Burks, MD
Wesley Burks, MD
- Executive Dean
- University of North Carolina School of Medicine
The evaluation of a patient with possible food allergy is a clinical exercise that includes some combination of the following diagnostic tools, although not all of these elements are necessary in every patient [1-6]:
●History and physical examination
●Prick/puncture skin testing
●In vitro testing
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- Aalberse RC, Stapel SO, Schuurman J, Rispens T. Immunoglobulin G4: an odd antibody. Clin Exp Allergy 2009; 39:469.
- Matsumoto N, Okochi M, Matsushima M, et al. Peptide array-based analysis of the specific IgE and IgG4 in cow's milk allergens and its use in allergy evaluation. Peptides 2009; 30:1840.
- Tomicić S, Norrman G, Fälth-Magnusson K, et al. High levels of IgG4 antibodies to foods during infancy are associated with tolerance to corresponding foods later in life. Pediatr Allergy Immunol 2009; 20:35.
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- Caubet JC, Bencharitiwong R, Moshier E, et al. Significance of ovomucoid- and ovalbumin-specific IgE/IgG(4) ratios in egg allergy. J Allergy Clin Immunol 2012; 129:739.
- Skripak JM, Nash SD, Rowley H, et al. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow's milk allergy. J Allergy Clin Immunol 2008; 122:1154.
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- ROLE OF ALLERGY TESTS IN DIAGNOSIS
- SKIN TESTING
- Prick/puncture skin tests
- - Precautions and preparations
- - Technique
- - Accuracy
- Intradermal skin tests
- Atopy patch tests
- IN VITRO TESTING
- Component testing
- Basophil histamine release
- TRIAL ELIMINATION DIETS
- FOOD DIARIES
- FOOD CHALLENGES
- UNVALIDATED METHODS
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS