Food allergy: Symptoms and diagnosis

Food allergy is common and has increased in prevalence over time. Although there are many types of reactions to foods, immunoglobulin E (IgE) mediated food allergy is acute in onset and resolves quickly, and is reproducible in nature. Anaphylaxis is the most severe form of IgE-mediated food allergy and has a range of clinical manifestations. First-line food allergy diagnostic testing is sensitive but not specific and should only be done in the context of a convincing history of a reaction. Oral food challenge is the criterion standard in diagnosis but carries the risk of a reaction. The only therapy for anaphylaxis is immediate intramuscular epinephrine. Traditional management of food allergy consists of avoidance management, with strict avoidance, reading labels, and carrying an epinephrine autoinjector at all times. Although effective, accidental reactions do occur, and this management strategy has a profound impact on quality of life.