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Improving Diagnostic Accuracy in Food Allergy.

Ru-Xin Foong1, Jennifer A Dantzer2, Robert A Wood2

  • 1Faculty of Life Sciences and Medicine, Department of Women and Children's Health (Paediatric Allergy), School of Life Course Sciences, King's College London, London, United Kingdom; Children's Allergy Service, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.

The Journal of Allergy and Clinical Immunology. in Practice
|January 12, 2021
PubMed
Summary

Accurate food allergy diagnosis is crucial. This review explores tests to improve diagnostic accuracy before oral food challenges, aiding clinical decisions.

Keywords:
Basophil activation testDiagnosisFood allergyMast cell activation testSkin prick testSpecific IgE

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Area of Science:

  • Allergy and Immunology
  • Clinical Diagnostics

Background:

  • Food allergy diagnosis significantly impacts patients' lives, necessitating accurate identification.
  • Misdiagnosis poses risks of severe reactions or unnecessary dietary restrictions.
  • Current diagnostic methods include clinical history and allergen-specific IgE, but interpretation can be challenging.

Purpose of the Study:

  • To review the predictive value of various tests for food allergy diagnosis.
  • To discuss the implications of diagnostic accuracy for therapy and prognosis.
  • To propose an improved diagnostic approach before oral food challenges.

Main Methods:

  • Review of existing literature on diagnostic tests for food allergy.
  • Analysis of the predictive value of allergen-specific IgE and other biomarkers.
  • Discussion of the role and limitations of oral food challenges (OFCs).

Main Results:

  • Allergen-specific IgE interpretation requires a clear clinical history.
  • Oral food challenges (OFCs) are the gold standard but are time-consuming and risky.
  • Several tests show predictive value in supporting food allergy diagnosis prior to OFCs.

Conclusions:

  • Improving diagnostic accuracy before OFCs is essential for patient safety and efficient care.
  • A structured diagnostic approach can optimize the use of available tests.
  • Accurate food allergy diagnosis guides appropriate management and improves patient outcomes.