[Food allergy in children: a diagnostic challenge]

Food allergy in children has increased unexpectedly during the last decades and is now the leading cause of anaphylaxis in Europe. The impact on quality of life is significant; a reliable diagnosis is therefore of critical importance. The diagnostic approach includes an initial clinical evaluation followed by allergy testing (in vivo and/or in vitro). Determination of molecular allergens (recombinants) has emerged as a complementary tool in the diagnosis of food allergy allowing a better prediction of systemic reactions and identifying markers of persistence or resolution. With recent developments, a more proactive approach is being adopted, which includes oral food challenges in order to avoid unnecessary exclusions.