Pearls and Pitfalls in Diagnosing IgE-Mediated Food Allergy

Abstract

The term "food allergy" is used by many patients and clinicians to describe a range of symptoms that occur after ingestion of specific foods. However, not all symptoms occurring after food exposure are due to an allergic, or immunologic, response. It is important to properly evaluate and diagnose immunoglobulin E (IgE)-mediated food allergy as this results in reproducible, immediate onset, allergic reactions that can progress toward life-threatening anaphylaxis. Proper diagnosis requires understanding of the common foods that cause these reactions in addition to key historical elements such as symptoms, timing and duration of reaction, and risk factors that may predispose to development of IgE-mediated food allergy. Diagnostic testing for food-specific IgE can greatly aid the diagnosis. However, false-positive test results are very common and can lead to overinterpretation, misdiagnosis, and unnecessary dietary elimination. This review discusses important aspects to consider during evaluation of a patient for suspected IgE-mediated food allergy.

Alergia alimentaria en pediatría: recomendaciones para su diagnóstico y tratamiento. Texto completo

“…S6 / Arch Argent Pediatr 2018;116 Supl 1:S1-S19 / Subcomisiones, Comités y Grupos de Trabajo demostrar la sensibilización IgE-mediada, debido a su seguridad, fácil realización, resultados inmediatos, bajo costo, reproducibilidad y alto valor predictivo, comparada con la PPC. 43,44 Puede realizarse a cualquier edad y permite evaluar múltiples alergenos al mismo tiempo.…”

“…41,44 Otorgan certeza si el alimento sospechoso es causante del síntoma. 62 Al reproducir síntomas y signos de la reacción, deberán realizarla médicos capacitados y en un…”

“…Su complejidad dificulta la aplicación en la práctica diaria. 44 Una PPC negativa demuestra ausencia de reacción con el alimento y provee seguridad para otorgar el alta.…”

Integrative Medicine for Gastrointestinal Disease

“…Food allergy testing is particularly challenging given the potential for false positives and false negatives and requires careful interpretation. 34 Providers can consider training in functional medicine to learn more or refer to an integrative medicine center that incorporates functional medicine testing.…”

Clinical manifestations of Type 1 allergic reactions

“…Gıda intoleransı belirtileri gastrointestinal sistem ile sınırlıdır. [8,9] Besin alerjisi, bir yiyeceğe (genellikle yutulması) maruz kaldıktan sonraki anormal immünolojik cevaptan kaynaklanır. Doku mast hücrelerinden ve dolaşımdaki bazofillerden mediatör salınımının yol açtığı düşünülmektedir.…”