Oral food challenge

An oral food challenge is a diagnostic test that is considered the most reliable method for identifying a food allergy, whether it is IgE or non-IgE-mediated. It is considered the gold standard for diagnosis and involves the consumption of the suspected allergen under medical supervision to determine if an allergic reaction occurs.From: Textbook of Allergy for the Clinician [2021], Cow milk protein allergy and other common food allergies and intolerances [2019]

Common Office Tests and Procedures for the Allergist

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Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021

Vinay Mehta

An oral food challenge provides the most definitive means to diagnose a food allergy. It is used to identify, confirm or rule out a suspected food allergy, and may prevent unnecessary food restrictions (Boyce et al. 2010). An oral food challenge in the outpatient setting should only be performed if the benefit to the patient of a negative result is greater than the risk of the testing, and only if previous skin prick or in vitro tests have concluded a high probability of a negative result. The Food Allergy & Anaphylaxis Network has published A Health Professional’s Guide to Food Challenges, which provides detailed information on conducting oral food challenges (Mofidi and Bock 2004).

Cow milk protein allergy and other common food allergies and intolerances

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Journal Information

Published in Paediatrics and International Child Health, 2019

Wiparat Manuyakorn, Pornthep Tanpowpong

There is a limited availability of tests for non-IgE-mediated food allergy typically related to the gastrointestinal tract. Patch tests with fresh foods is not recommended because of a lack of validity, standardised testing material and interpretation of results [17]. Measurement of food-specific IgG for the diagnosis of non-IgE food allergy is not recommended [16]. The gold standard for diagnosis for both IgE and non-IgE-mediated food allergy is an oral food challenge test. Diagnosis of cow milk allergy in a preterm infant is challenging since preterm infants with cow milk allergy could present with feeding intolerance, asepsis-like episodes and eosinophilia which are common findings in sick preterm infants [19].

Oral food challenge

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Common Office Tests and Procedures for the Allergist

Cow milk protein allergy and other common food allergies and intolerances