Clinical Recognition of the Child with Food Allergy

Abstract

The multiplicity of poorly defined illnesses and the variability of pathological lesions induced by various foods in sensitized children have led to a reluctance to recognize various forms of food allergy and to confusion with other forms of food intolerance. Many paediatricians have become increasingly sceptical of various clinical illnesses attributed to food allergy due to evidence that many adults with such illnesses suffer from psychiatric disorders [1] and to the recent recognition that restriction of food intake in childhood, incorrectly attributed to food allergy, constitutes a concealed form of child abuse [2]. In this discussion, food allergy is defined as an adverse reaction to a food substance which is attributed to an immunological hypersensitivity. This concept implies an interaction between one or more food antigens with one or more immune mechanisms leading to the adverse clinical response. Thus, the following discussions confined to IgE-associated conditions, and the terms food allergy and food-protein intolerance are used interchangeably.