Pediatric Annals

CME Article 

Food Allergy: Diagnosis, Treatment, Prognosis, and Prevention

Jennifer S. Kim, MD

Abstract

As with most diseases in medicine, a detailed medical history obtained by a skilled and knowledgeable healthcare provider is crucial in reaching a diagnosis of food allergy. Therefore, patient (or parental) perceptions with regards to food allergy are notoriously inaccurate. Parents often have very strongly held beliefs that various foods cause a variety of symptoms, many of which are inconsistent with an immune-mediated process. In fact, when double-blind, placebo-controlled, food challenges (DBPCFCs) are used to establish the diagnosis of IgE-mediated food allergy, only about 40% of patients’ histories of food-induced reactions can be verified. Therefore, this article focuses on how to obtain historical highlights and use the available diagnostic tools, as well as treatment and prognosis of IgE-mediated food allergy.

ABOUT THE AUTHOR

Jennifer S. Kim, MD, is Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine, and Attending Physician, Division of Allergy and Immunology, Children’s Memorial Hospital. Address correspondence to: jskim@childrensmemorial.org.

Dr. Kim has disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Determine the most effective means to obtain historical information that may illuminate foods that are causing an allergic reaction.
  2. Discuss the appropriate use and interpretation of available diagnostic tools in the evaluation of food allergies.
  3. Assess the currently recommended treatment and prevention of IgE-mediated food allergy.

Abstract

As with most diseases in medicine, a detailed medical history obtained by a skilled and knowledgeable healthcare provider is crucial in reaching a diagnosis of food allergy. Therefore, patient (or parental) perceptions with regards to food allergy are notoriously inaccurate. Parents often have very strongly held beliefs that various foods cause a variety of symptoms, many of which are inconsistent with an immune-mediated process. In fact, when double-blind, placebo-controlled, food challenges (DBPCFCs) are used to establish the diagnosis of IgE-mediated food allergy, only about 40% of patients’ histories of food-induced reactions can be verified. Therefore, this article focuses on how to obtain historical highlights and use the available diagnostic tools, as well as treatment and prognosis of IgE-mediated food allergy.

ABOUT THE AUTHOR

Jennifer S. Kim, MD, is Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine, and Attending Physician, Division of Allergy and Immunology, Children’s Memorial Hospital. Address correspondence to: jskim@childrensmemorial.org.

Dr. Kim has disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Determine the most effective means to obtain historical information that may illuminate foods that are causing an allergic reaction.
  2. Discuss the appropriate use and interpretation of available diagnostic tools in the evaluation of food allergies.
  3. Assess the currently recommended treatment and prevention of IgE-mediated food allergy.

As with most diseases in medicine, a detailed medical history obtained by a skilled and knowledgeable healthcare provider is crucial in reaching a diagnosis of food allergy. Therefore, patient (or parental) perceptions with regards to food allergy are notoriously inaccurate. Parents often have very strongly held beliefs that various foods cause a variety of symptoms, many of which are inconsistent with an immune-mediated process. In fact, when double-blind, placebo-controlled, food challenges (DBPCFCs) are used to establish the diagnosis of IgE-mediated food allergy, only about 40% of patients’ histories of food-induced reactions can be verified. Therefore, this article focuses on how to obtain historical highlights and use the available diagnostic tools, as well as treatment and prognosis of IgE-mediated food allergy.

ABOUT THE AUTHOR

Jennifer S. Kim, MD, is Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine, and Attending Physician, Division of Allergy and Immunology, Children’s Memorial Hospital. Address correspondence to: jskim@childrensmemorial.org.

Dr. Kim has disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Determine the most effective means to obtain historical information that may illuminate foods that are causing an allergic reaction.
  2. Discuss the appropriate use and interpretation of available diagnostic tools in the evaluation of food allergies.
  3. Assess the currently recommended treatment and prevention of IgE-mediated food allergy.

10.3928/00904481-20080801-07

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