Oral Food Challenge

Calvani, Mauro; Bianchi, Annamaria; Reginelli, Chiara; Peresso, Martina; Testa, Alessia

doi:10.3390/medicina55100651

Cited by 52 publications

(57 citation statements)

References 78 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The OFC with the culprit food is still considered the gold standard for the diagnosis of food-expensive induced allergy, best if conducted in a double-blind placebo-controlled way [ 6 , 8 ]. Considering its costs, time-consuming and risk of severe reactions, OFC should be performed in an appropriate setting by well-trained personnel: thus, in real life, only few OFC are really performed [ 6 , 8 , 24 ]. Considering these aspects, the presence of suggestive symptoms of IgE-mediated reaction, and the evidence of hazelnuts specific IgE (sIgE) (positive results on skin prick test or elevated specific IgE), constitute the mainstay of the diagnosis of hazelnut allergy [ 9 ].…”

Section: Diagnosis Of Hazelnut Allergymentioning

confidence: 99%

Hazelnut Allergy

Calamelli¹,

Trozzo

Blasi

et al. 2021

Medicina

View full text Add to dashboard Cite

Background and Objectives: Hazelnuts are frequently involved in IgE-mediated reactions and represent the main culprit of nut allergy in Europe. The clinical presentation varies from mild symptoms limited to the oropharynx [oral allergy syndrome (OAS)], due to the cross-reaction with homologues in pollen allergens and more severe events caused by the primary sensitization to highly stable molecules contained in hazelnuts. The aim of this review is to summarize the most relevant concepts in the field of hazelnut allergy and to provide a practical approach useful in the clinical practice Materials and Methods: References were identified by PubMed searches dating from January 2000 up to November 2020 using the search terms: “component resolved diagnosis” and “Hazelnut allergy. Results: The storage proteins Cor a 9 and Cor a 14 resulted highly specific for primary hazelnut allergy and strongly associated with severe reactions, while the cross reactive Cor a 1, an homolog of the birch Bet v1, were related to OAS. Any cut-off has shown a specificity and sensitivity pattern as high as to replace the oral food challenge (OFC), which still remains the gold standard in the diagnosis of hazelnut allergy. To date there is still no definitive treatment. Hazelnut free-diet and treatment of symptoms with emergency management, including the prescription of auto-injective epinephrine, still represent the main approach. Oral allergen immunotherapy (AIT) appears a promising therapeutic strategy and the definition of individual clinical threshold would be useful for sensitized individuals, caregivers, and physicians to reduce social limitation, anxiety, and better manage food allergy. Conclusions: An accurate diagnostic work-up including clinical history, in vivo and in vitro test including component resolved diagnosis and OFC are essential to confirm the diagnosis, to assess the risk of a severe reaction, and to prescribe an adequate diet and treatment.

show abstract

Section: Diagnosis Of Hazelnut Allergymentioning

confidence: 99%

Hazelnut Allergy

Calamelli¹,

Trozzo

Blasi

et al. 2021

Medicina

View full text Add to dashboard Cite

show abstract

“…This demonstrates that although the food challenge test is a timeconsuming test, requires considerable effort and experience, and carries the risk of severe reactions, yet, it is essential for accurate diagnosis. 9,41 Allergists must always consider that diagnosis of food allergy would be followed by food elimination which implies a substantial constrains on the quality of life, cost of living and causes nutritional deficiencies which is critical in adults and typically more in pediatric population, so diagnosis of food allergy should be as accurate as possible.…”

Section: Discussionmentioning

confidence: 99%

Patterns of sensitization to food allergens among allergic adults and children following-up in Zagazig university hospitals, Egypt

Shabrawy

Elrafey

2021

Egypt J Pediatr Allergy Immunol

View full text Add to dashboard Cite

Background: Data regarding food sensitization and food allergy in developing countries are lacking. We sought to explore the frequency and pattern of sensitization to food allergens among a sample of Egyptian allergic patients. Methods: This cross-sectional study included 1373 allergic patients. They were subjected to thorough history taking, skin prick test, serum specific IgE (sIgE) level. Patients with evidence of sensitization to food were subjected to food elimination followed by an open oral food challenge (OFC) test. Results: Four-hundreds and nineteen patients (30.5%) (76 children and 343 adults) had evidence of sensitization to one or more food allergen.

show abstract

“…OFC may occasionally be required to make a definitive diagnosis of a FA. Still, with the advent of more specific diagnostic methods (such as allergen component testing and basophil activation test), the level of risk involved and the resource-intensive nature of conducting an OFC calls for its use only for equivocal cases [ 19 ]. In consensus with the FA practice parameter update [ 20 ], if the patient has a convincing clinical history of an allergic response to the allergen, then performing OFC is deemed as high-risk and should ideally not be performed [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…OFC calls for its use only for equivocal cases [19]. In consensus with the FA practice parameter update [20], if the patient has a convincing clinical history of an allergic response to the allergen, then performing OFC is deemed as high-risk and should ideally not be performed [21].…”

Section: Plos Onementioning

confidence: 99%

A study to assess current approaches of allergists in European countries diagnosing and managing children and adolescents with peanut allergy

Sharma

Jobrack²,

Cerenzia

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

Rationale Food allergy is documented to result in considerable morbidity, negative impact on quality of life, and substantial medical care costs. Although anecdotal data suggest widely varying practices in the diagnosis and management of food allergies, the diversity and relative frequency of these practices have not been documented. Methods A questionnaire was developed evaluating allergists’ management approaches of individuals with peanut allergy (PA) in Germany (DE), France (FR), and the United Kingdom (UK). Results Here, we report the survey results from a total of 109 allergists from DE, FR and the UK. They reported to confirm PA at initial diagnosis using skin prick test (≥60%), while allergists from DE and FR reported using allergen-specific IgE testing more (>86%) compared to the UK (<50%). At initial diagnosis, oral food challenge was used less in DE (13%) and FR (14%) and very rarely in the UK (3%) to confirm diagnosis. Recognition of acute reactions, use of adrenaline auto-injectors and allergen avoidance were reported to be discussed with the patient/caregiver at the initial office visit by most allergists (>75%). Half of the responders reported assessing the patient’s quality of life. 63% allergists reported retesting for PA resolution at a later date, with 45% allergists indicated to recommend ingestion of a normal serving of peanut regularly upon resolution. Lack of effective PA treatment was reported to be a ‘very significant’ barrier for optimal PA treatment, with allergists being less than ‘moderately familiar’ with data from clinical trials testing new treatments options for PA. Lastly, allergists stated that the severity of patient’s PA ranked as the most important factor in their decision to recommend oral immunotherapy for PA treatment. Conclusions This survey provides essential insights into the practice of allergists and highlights some areas that would inform strategies for education and improving PA healthcare.

show abstract

Oral Food Challenge

Cited by 52 publications

References 78 publications

Hazelnut Allergy

Hazelnut Allergy

Patterns of sensitization to food allergens among allergic adults and children following-up in Zagazig university hospitals, Egypt

A study to assess current approaches of allergists in European countries diagnosing and managing children and adolescents with peanut allergy

Contact Info

Product

Resources

About