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Food allergies are a growing global concern. Food allergies affect both children and adults, totaling as many as 550 million people globally.1 Unfortunately, many patients are sensitive to more than one food.2
Allergic reactions can happen within minutes of coming in contact with an allergen. Though some patients experience relatively mild symptoms like urticaria (hives), others are at risk of a severe reaction like anaphylaxis.3 Food allergies, particularly in children, can lead to social issues, with affected children being excluded from school lunchrooms or activities.1 Their parents may need to take time off work to care for their children, causing an economic burden, and adult patients may end up avoiding foods that contain much needed protein, vitamins, and minerals.1
Most common food allergens2
of food allergies are caused by 8 allergens: peanuts, tree nuts, milk, egg, soy, wheat, fish and shellfish
Preventing a reaction, unnecessary diet restrictions, or poor socio-economic outcomes starts by understanding the type of food allergy the patient has. Based on the presentation of the patient’s symptoms, a healthcare provider may begin to suspect that an allergy is immune- or non-immune mediated. Non-immune mediated reactions are considered to be food intolerances, while immune-mediated reactions are true food allergies that involve certain cells or antibodies, including IgE. The testing you conduct will give healthcare providers the information necessary to narrow down the cause of the patient’s food reactions and determine the most appropriate course of treatment.4
Several guidelines exist that aid clinicians in the creation of personalized management strategies for patients with food allergies. These guidelines may promote the use of IgE testing—specific IgE tests, skin prick tests (SPT), or a combination—in combination with the findings from a patient history and physical exam to pinpoint the cause of a patient’s food reactions and his or her exact sensitivities.
Understanding the pathogenesis of a patient’s food allergy gives the healthcare provider increased diagnostic certainty. Diagnostic test results allow providers to not only understand the allergens at play but to also clarify the landscape of a patient’s allergic symptoms.4 Ultimately, the results you deliver allow providers and patients to work toward developing a management plan that includes eliminating only relevant foods, thus avoiding potentially deadly reactions and other far-reaching effects.
Treatment for food allergies relies on avoiding the relevant allergen.3 Occasionally, antihistamines are needed to manage non-severe symptoms.2 It is critical that a healthcare provider be able to accurately identify which foods a patient is sensitized to. Without that specific information, a patient may be incorrectly advised to eliminate potentially beneficial food from his or her diet or, worse yet, continue on at risk for a severe, potentially fatal reaction.3 Subsequent to the identification of sensitization to whole allergens, identifying relevant allergen components can allow clinicians to personalize the management of their patients’ allergies. Oral immunotherapy (OIT) is an emerging treatment for food allergy, but still, no cure is currently available to healthcare providers or patients.3
Pawankar R, Holgate ST, Canonica GW, et al. World Allergy Organization (WAO) White Book on Allergy. 2013. http://www.worldallergy.org/UserFiles/file/WhiteBook2-2013-v8.pdf. Accessed November 2017.
Kurowski K, Boxer RW. Food allergies: detection and management. Am Fam Physician. 2008;77:1678-1688.
Burks AW, Tang M, Sicherer S, et al. ICON: Food allergy. J Allergy Clin Immunol. 2012;129:906-920.
Manea I, Ailenei E, Deleanu D. Overview of food allergy diagnosis. Clujul Med. 2016;89(1):5-10.
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