Diagnosis of food allergy

Epicutaneous skin tests, in vitro tests, and oral food challenge

Jay Lieberman, Scott H. Sicherer

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Food allergy is becoming an increasingly common diagnosis. Because of this increase in prevalence, it is imperative that physicians evaluating patients with possible adverse reactions to foods understand the currently available assays and how they should best be used to accurately diagnose the disease. Simple tests such as skin prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests, which measure sensitization and not clinical allergy, are not without pitfalls, and their utility must be appreciated to avoid over- and underdiagnosis. Although the physician-supervised oral food challenge remains the gold standard for food allergy diagnosis, a careful medical history paired with SPT and serum food-specific IgE testing often can provide a reliable diagnosis. In this review, we examine the usefulness and pitfalls of SPT and serum food-specific IgE levels, as well as examine atopy patch testing and other emerging tests, such as component-resolved diagnostics and the basophil activation test. Finally, we describe the use of the double-blind, placebo-controlled oral food challenge as the current gold standard for food allergy diagnosis.

Original languageEnglish (US)
Pages (from-to)58-64
Number of pages7
JournalCurrent Allergy and Asthma Reports
Volume11
Issue number1
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Food Hypersensitivity
Skin Tests
Food
Immunoglobulin E
Skin
Serum
Physicians
Basophils
In Vitro Techniques
Routine Diagnostic Tests
Hypersensitivity
Placebos

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

Diagnosis of food allergy : Epicutaneous skin tests, in vitro tests, and oral food challenge. / Lieberman, Jay; Sicherer, Scott H.

In: Current Allergy and Asthma Reports, Vol. 11, No. 1, 01.02.2011, p. 58-64.

Research output: Contribution to journalArticle

@article{350037245be24e399d90c1750134ebf6,
title = "Diagnosis of food allergy: Epicutaneous skin tests, in vitro tests, and oral food challenge",
abstract = "Food allergy is becoming an increasingly common diagnosis. Because of this increase in prevalence, it is imperative that physicians evaluating patients with possible adverse reactions to foods understand the currently available assays and how they should best be used to accurately diagnose the disease. Simple tests such as skin prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests, which measure sensitization and not clinical allergy, are not without pitfalls, and their utility must be appreciated to avoid over- and underdiagnosis. Although the physician-supervised oral food challenge remains the gold standard for food allergy diagnosis, a careful medical history paired with SPT and serum food-specific IgE testing often can provide a reliable diagnosis. In this review, we examine the usefulness and pitfalls of SPT and serum food-specific IgE levels, as well as examine atopy patch testing and other emerging tests, such as component-resolved diagnostics and the basophil activation test. Finally, we describe the use of the double-blind, placebo-controlled oral food challenge as the current gold standard for food allergy diagnosis.",
author = "Jay Lieberman and Sicherer, {Scott H.}",
year = "2011",
month = "2",
day = "1",
doi = "10.1007/s11882-010-0149-4",
language = "English (US)",
volume = "11",
pages = "58--64",
journal = "Current Allergy and Asthma Reports",
issn = "1529-7322",
publisher = "Current Medicine Group",
number = "1",

}

TY - JOUR

T1 - Diagnosis of food allergy

T2 - Epicutaneous skin tests, in vitro tests, and oral food challenge

AU - Lieberman, Jay

AU - Sicherer, Scott H.

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Food allergy is becoming an increasingly common diagnosis. Because of this increase in prevalence, it is imperative that physicians evaluating patients with possible adverse reactions to foods understand the currently available assays and how they should best be used to accurately diagnose the disease. Simple tests such as skin prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests, which measure sensitization and not clinical allergy, are not without pitfalls, and their utility must be appreciated to avoid over- and underdiagnosis. Although the physician-supervised oral food challenge remains the gold standard for food allergy diagnosis, a careful medical history paired with SPT and serum food-specific IgE testing often can provide a reliable diagnosis. In this review, we examine the usefulness and pitfalls of SPT and serum food-specific IgE levels, as well as examine atopy patch testing and other emerging tests, such as component-resolved diagnostics and the basophil activation test. Finally, we describe the use of the double-blind, placebo-controlled oral food challenge as the current gold standard for food allergy diagnosis.

AB - Food allergy is becoming an increasingly common diagnosis. Because of this increase in prevalence, it is imperative that physicians evaluating patients with possible adverse reactions to foods understand the currently available assays and how they should best be used to accurately diagnose the disease. Simple tests such as skin prick testing (SPT) and serum food-specific IgE testing are the most commonly used diagnostic tests to evaluate for IgE-mediated food reactions. However, these tests, which measure sensitization and not clinical allergy, are not without pitfalls, and their utility must be appreciated to avoid over- and underdiagnosis. Although the physician-supervised oral food challenge remains the gold standard for food allergy diagnosis, a careful medical history paired with SPT and serum food-specific IgE testing often can provide a reliable diagnosis. In this review, we examine the usefulness and pitfalls of SPT and serum food-specific IgE levels, as well as examine atopy patch testing and other emerging tests, such as component-resolved diagnostics and the basophil activation test. Finally, we describe the use of the double-blind, placebo-controlled oral food challenge as the current gold standard for food allergy diagnosis.

UR - http://www.scopus.com/inward/record.url?scp=79551573074&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79551573074&partnerID=8YFLogxK

U2 - 10.1007/s11882-010-0149-4

DO - 10.1007/s11882-010-0149-4

M3 - Article

VL - 11

SP - 58

EP - 64

JO - Current Allergy and Asthma Reports

JF - Current Allergy and Asthma Reports

SN - 1529-7322

IS - 1

ER -