Skip to main content

Part of the book series: Allergy Frontiers ((ALLERGY,volume 4))

  • 675 Accesses

The diagnosis of food allergy derives from the clinical history and the results of supporting tests. To obtain the most information from the clinical history, and for appropriate test selection and interpretation, the clinician must incorporate a knowledge of the epidemiology and pathophysiology underlying food allergic diseases. Food-specific IgE antibodies measured by prick skin testing and/or serum assay often provide important diagnostic information. Elimination diets and physician supervised oral food challenges may be needed to confirm a diagnosis when the history and test results are otherwise not diagnostic or when simple diagnostic tests are not available. Tests under investigation may provide improved diagnostic accuracy and additional insights, such as severity and natural course of food allergies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004; 113(5):832–836.

    Article  PubMed  CAS  Google Scholar 

  2. Sicherer SH, Teuber S. Current approach to the diagnosis and management of adverse reactions to foods. J Allergy Clin Immunol 2004; 114(5):1146–1150.

    Article  PubMed  Google Scholar 

  3. Sicherer SH, Sampson HA. 9. Food allergy. J Allergy Clin Immunol 2006; 117(2 Suppl Mini-Primer):S470–S475.

    Article  PubMed  CAS  Google Scholar 

  4. Food allergy: a practice parameter. Ann Allergy Asthma Immunol 2006; 96(3 Suppl 2):S1–68.

    Google Scholar 

  5. Chatterjee U, Mondal G, Chakraborti P, Patra HK, Chatterjee BP. Changes in the Allergenicity during Different Preparations of Pomfret, Hilsa, Bhetki and Mackerel Fish as Illustrated by Enzyme-Linked Immunosorbent Assay and Immunoblotting. Int Arch Allergy Immunol 2006; 141(1):1–10.

    Article  PubMed  CAS  Google Scholar 

  6. Untersmayr E, Scholl I, Swoboda I, Beil WJ, Forster-Waldl E, Walter F et al. Antacid medication inhibits digestion of dietary proteins and causes food allergy: a fish allergy model in BALB/c mice. J Allergy Clin Immunol 2003; 112(3):616–623.

    Article  PubMed  CAS  Google Scholar 

  7. Untersmayr E, Poulsen LK, Platzer MH, Pedersen MH, Boltz-Nitulescu G, Skov PS et al. The effects of gastric digestion on codfish allergenicity. J Allergy Clin Immunol 2005; 115(2):377–382.

    Article  PubMed  CAS  Google Scholar 

  8. Untersmayr E, Bakos N, Scholl I, Kundi M, Roth-Walter F, Szalai K et al. Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients. FASEB J 2005; 19(6):656–658.

    PubMed  CAS  Google Scholar 

  9. Lim DL, Neo KH, Goh DL, Shek LP, Lee BW. Missing parvalbumin: implications in diagnostic testing for tuna allergy. J Allergy Clin Immunol 2005; 115(4):874–875.

    Article  PubMed  CAS  Google Scholar 

  10. Kobayashi A, Tanaka H, Hamada Y, Ishizaki S, Nagashima Y, Shiomi K. Comparison of allergenicity and allergens between fish white and dark muscles. Allergy 2006; 61(3):357–363.

    Article  PubMed  CAS  Google Scholar 

  11. Asturias JA, Eraso E, Moneo I, Martinez A. Is tropomyosin an allergen in Anisakis? Allergy 2000; 55(9):898–899.

    Article  PubMed  CAS  Google Scholar 

  12. Sastre J, Lluch-Bernal M, Quirce S, Arrieta I, Lahoz C, Del Amo A et al. A double-blind, placebo-controlled oral challenge study with lyophilized larvae and antigen of the fish parasite, Anisakis simplex. Allergy 2000; 55(6):560–564.

    Article  PubMed  CAS  Google Scholar 

  13. Baeza ML, Rodriguez A, Matheu V, Rubio M, Tornero P, de Barrio M et al. Characterization of allergens secreted by Anisakis simplex parasite: clinical relevance in comparison with somatic allergens. Clin Exp Allergy 2004; 34(2):296–302.

    Article  PubMed  CAS  Google Scholar 

  14. Daschner A, Pascual CY. Anisakis simplex: sensitization and clinical allergy. Curr Opin Allergy Clin Immunol 2005; 5(3):281–285.

    PubMed  Google Scholar 

  15. Asero R. Plant food allergies: a suggested approach to allergen-resolved diagnosis in the clinical practice by identifying easily available sensitization markers. Int Arch Allergy Immunol 2005; 138(1):1–11.

    Article  PubMed  CAS  Google Scholar 

  16. Roberts G, Lack G. Diagnosing peanut allergy with skin prick and specific IgE testing. J Allergy Clin Immunol 2005; 115(6):1291–1296.

    Article  PubMed  CAS  Google Scholar 

  17. Ho MH, Heine RG, Wong W, Hill DJ. Diagnostic accuracy of skin prick testing in children with tree nut allergy. J Allergy Clin Immunol 2006; 117(6):1506–1508.

    Article  PubMed  Google Scholar 

  18. Knight AK, Shreffler WG, Sampson HA, Sicherer SH, Noone S, Mofidi S et al. Skin prick test to egg white provides additional diagnostic utility to serum egg white-specific IgE antibody concentration in children. J Allergy Clin Immunol 2006; 117(4):842–847.

    Article  PubMed  CAS  Google Scholar 

  19. Sporik R, Hill DJ, Hosking CS. Specificity of allergen skin testing in predicting positive open food challenges to milk, egg and peanut in children. Clin Exp Allergy 2000; 30(11):1541–1546.

    Article  Google Scholar 

  20. Verstege A, Mehl A, Rolinck-Werninghaus C, Staden U, Nocon M, Beyer K et al. The predictive value of the skin prick test weal size for the outcome of oral food challenges. Clin Exp Allergy 2005; 35(9):1220–1226.

    Article  PubMed  CAS  Google Scholar 

  21. Codreanu F, Moneret-Vautrin DA, Morisset M, Guenard L, Rance F, Kanny G et al. The risk of systemic reactions to skin prick-tests using food allergens: CICBAA data and literature review. Allerg Immunol (Paris) 2006; 38(2):52–54.

    CAS  Google Scholar 

  22. Devenney I, Falth-Magnusson K. Skin prick tests may give generalized allergic reactions in infants. Ann Allergy Asthma Immunol 2000; 85(6 Pt 1):457–460.

    PubMed  CAS  Google Scholar 

  23. Bernstein DI, Wanner M, Borish L, Liss GM. Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990–2001. J Allergy Clin Immunol 2004; 113(6):1129–1136.

    Article  PubMed  Google Scholar 

  24. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 2001; 107(5):891–896.

    Article  PubMed  CAS  Google Scholar 

  25. Maloney JM, Rudengren M, Ahlstedt S, Bock SA, Sampson HA. The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy. J Allergy Clin Immunol 2008; 122(1):145–151.

    Article  PubMed  CAS  Google Scholar 

  26. Perry TT, Matsui EC, Kay Conover-Walker M, Wood RA. The relationship of allergen-specific IgE levels and oral food challenge outcome. J Allergy Clin Immunol 2004; 114(1):144–149.

    Article  PubMed  CAS  Google Scholar 

  27. Celik-Bilgili S, Mehl A, Verstege A, Staden U, Nocon M, Beyer K et al. The predictive value of specific immunoglobulin E levels in serum for the outcome of oral food challenges. Clin Exp Allergy 2005; 35(3):268–273.

    Article  PubMed  CAS  Google Scholar 

  28. Boyano-Martinez T, Garcia-Ara C, Diaz-Pena JM, Martin-Esteban M. Prediction of tolerance on the basis of quantification of egg white- specific IgE antibodies in children with egg allergy. J Allergy Clin Immunol 2002; 110(2):304–309.

    Article  PubMed  CAS  Google Scholar 

  29. Mehl A, Rolinck-Werninghaus C, Staden U, Verstege A, Wahn U, Beyer K et al. The atopy patch test in the diagnostic workup of suspected food-related symptoms in children. J Allergy Clin Immunol 2006; 118(4):923–929.

    Article  PubMed  Google Scholar 

  30. Komata T, Soderstrom L, Borres MP, Tachimoto H, Ebisawa M. The predictive relationship of food-specific serum IgE concentrations to challenge outcomes for egg and milk varies by patient age. J Allergy Clin Immunol 2007;119(5):1272–1274.

    Article  PubMed  CAS  Google Scholar 

  31. Wang J, Godbold JH, Sampson HA. Correlation of serum allergy (IgE) tests performed by different assay systems. J Allergy Clin Immunol 2008; 121(5):1219–1224.

    Article  PubMed  CAS  Google Scholar 

  32. Shek LP, Soderstrom L, Ahlstedt S, Beyer K, Sampson HA. Determination of food specific IgE levels over time can predict the development of tolerance in cow's milk and hen's egg allergy. J Allergy Clin Immunol 2004; 114(2):387–391.

    Article  PubMed  CAS  Google Scholar 

  33. Sicherer SH, Sampson HA. Cow's milk protein-specific IgE concentrations in two age groups of milk-allergic children and in children achieving clinical tolerance [In Process Citation]. Clin Exp Allergy 1999; 29(4):507–512.

    Article  PubMed  CAS  Google Scholar 

  34. Isolauri E, Turjanmaa K. Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. J Allergy Clin Immunol 1996; 97(1 Pt 1):9–15.

    Article  PubMed  CAS  Google Scholar 

  35. Roehr CC, Reibel S, Ziegert M, Sommerfeld C, Wahn U, Niggemann B. Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. J Allergy Clin Immunol 2001; 107(3):548–553.

    Article  PubMed  CAS  Google Scholar 

  36. Majamaa H, Moisio P, Holm K, Kautiainen H, Turjanmaa K. Cow's milk allergy: diagnostic accuracy of skin prick and patch tests and specific IgE [In Process Citation]. Allergy 1999; 54(4):346–351.

    Article  PubMed  CAS  Google Scholar 

  37. Spergel JM, Andrews T, Brown-Whitehorn TF, Beausoleil JL, Liacouras CA. Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests. Ann Allergy Asthma Immunol 2005; 95(4):336–343.

    PubMed  Google Scholar 

  38. Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. Atopy patch test for the diagnosis of food protein-induced enterocolitis syndrome. Pediatr Allergy Immunol 2006; 17(5):351–355.

    Article  PubMed  Google Scholar 

  39. Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterol 2007; 133(4):1342–1363.

    Article  CAS  Google Scholar 

  40. Sicherer SH, Sampson HA. Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol 1999; 104(3 Pt 2):S114–S122.

    Article  PubMed  CAS  Google Scholar 

  41. Flinterman AE, Knulst AC, Meijer Y, Bruijnzeel-Koomen CA, Pasmans SG. Acute allergic reactions in children with AEDS after prolonged cow's milk elimination diets. Allergy 2006; 61(3):370–374.

    Article  PubMed  CAS  Google Scholar 

  42. David TJ. Anaphylactic shock during elimination diets for severe atopic dermatitis. Arch Dis Child 1984; 59:983–986.

    Article  PubMed  CAS  Google Scholar 

  43. Roesler TA, Barry PC, Bock SA. Factitious food allergy and failure to thrive. Arch Pediatr Adolesc Med 1994; 148(11):1150–1155.

    PubMed  CAS  Google Scholar 

  44. Sicherer SH, Noone SA, Munoz-Furlong A. The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol 2001; 87(6):461–464.

    PubMed  CAS  Google Scholar 

  45. Sicherer SH. Food allergy: when and how to perform oral food challenges [In Process Citation]. Pediatr Allergy Immunol 1999; 10(4):226–234.

    Article  PubMed  CAS  Google Scholar 

  46. Bock SA, Sampson HA, Atkins FM, Zeiger RS, Lehrer S, Sachs M et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: A manual. J Allergy Clin Immunol 1988; 82:986–997.

    Google Scholar 

  47. Niggemann B, Rolinck-Werninghaus C, Mehl A, Binder C, Ziegert M, Beyer K. Controlled oral food challenges in children — when indicated, when superfluous? Allergy 2005; 60(7):865–870.

    Article  PubMed  CAS  Google Scholar 

  48. Bindslev-Jensen C. Standardization of double-blind, placebo-controlled food challenges. Allergy 2001; 56(Suppl 67):75–77.

    Article  PubMed  Google Scholar 

  49. Caffarelli C, Petroccione T. False-negative food challenges in children with suspected food allergy. Lancet 2001; 358(9296):1871–1872.

    Article  PubMed  CAS  Google Scholar 

  50. Sampson HA. Use of food-challenge tests in children. Lancet 2001; 358(9296):1832–1833.

    Article  PubMed  CAS  Google Scholar 

  51. Briggs D, Aspinall L, Dickens A, Bindslev-Jensen C. Statistical model for assessing the proportion of subjects with subjective sensitisations in adverse reactions to foods. Allergy 2001; 56(Suppl 67):83–85.

    Article  PubMed  Google Scholar 

  52. Chinchilli VM, Fisher L, Craig TJ. Statistical issues in clinical trials that involve the double-blind, placebo-controlled food challenge. J Allergy Clin Immunol 2005; 115(3):592–597.

    Article  PubMed  Google Scholar 

  53. Bindslev-Jensen C, Ballmer-Weber BK, Bengtsson U, Blanco C, Ebner C, Hourihane J et al. Standardization of food challenges in patients with immediate reactions to foods — position paper from the European Academy of Allergology and Clinical Immunology. Allergy 2004; 59(7):690–697.

    Article  PubMed  CAS  Google Scholar 

  54. Niggemann B, Wahn U, Sampson HA. Proposals for standardization of oral food challenge tests in infants and children. Pediatr Allergy Immunol 1994; 5(1):11–3.

    Article  PubMed  CAS  Google Scholar 

  55. Niggemann B, Beyer K. Pitfalls in double-blind, placebo-controlled oral food challenges. Allergy 2007; 62(7):729–732.

    Article  PubMed  CAS  Google Scholar 

  56. Niggemann B, Beyer K. Diagnosis of food allergy in children: toward a standardization of food challenge. J Pediatr Gastroenterol Nutr 2007; 45(4):399–404.

    Article  PubMed  CAS  Google Scholar 

  57. Sicherer SH. Food protein-induced enterocolitis syndrome: case presentations and management lessons. J Allergy Clin Immunol 2005; 115(1):149–156.

    Article  PubMed  Google Scholar 

  58. Moffitt JE, Golden DB, Reisman RE, Lee R, Nicklas R, Freeman T et al. Stinging insect hyper-sensitivity: a practice parameter update. J Allergy Clin Immunol 2004; 114(4):869–886.

    Article  PubMed  Google Scholar 

  59. Hauswirth DW, Burks AW. Banana anaphylaxis with a negative commercial skin test. J Allergy Clin Immunol 2005; 115(3):632–633.

    Article  PubMed  Google Scholar 

  60. Chatchatee P, Jarvinen KM, Bardina L, Beyer K, Sampson HA. Identification of IgE- and IgG-binding epitopes on alpha(s1)-casein: differences in patients with persistent and transient cow's milk allergy. J Allergy Clin Immunol 2001; 107(2):379–383.

    Article  PubMed  CAS  Google Scholar 

  61. Beyer K, Jarvinen KM, Bardina L, Mishoe M, Turjanmaa K, Niggemann B et al. IgE-binding peptides coupled to a commercial matrix as a diagnostic instrument for persistent cow's milk allergy. J Allergy Clin Immunol 2005; 116(3):704–745.

    Article  PubMed  CAS  Google Scholar 

  62. Shreffler WG, Beyer K, Chu TH, Burks AW, Sampson HA. Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes. J Allergy Clin Immunol 2004; 113(4):776–782.

    Article  PubMed  CAS  Google Scholar 

  63. Shreffler WG, Lencer DA, Bardina L, Sampson HA. IgE and IgG4 epitope mapping by microarray immunoassay reveals the diversity of immune response to the peanut allergen, Ara h 2. J Allergy Clin Immunol 2005; 116(4):893–899.

    Article  PubMed  CAS  Google Scholar 

  64. Astier C, Morisset M, Roitel O, Codreanu F, Jacquenet S, Franck P et al. Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy. J Allergy Clin Immunol 2006; 118(1):250–256.

    Article  PubMed  CAS  Google Scholar 

  65. Ballmer-Weber BK, Scheurer S, Fritsche P, Enrique E, Cistero-Bahima A, Haase T et al. Component-resolved diagnosis with recombinant allergens in patients with cherry allergy. J Allergy Clin Immunol 2002; 110(1):167–173.

    Article  PubMed  CAS  Google Scholar 

  66. Lidholm J, Ballmer-Weber BK, Mari A, Vieths S. Component-resolved diagnostics in food allergy. Curr Opin Allergy Clin Immunol 2006; 6(3):234–240.

    Article  PubMed  CAS  Google Scholar 

  67. Schocker F, Luttkopf D, Scheurer S, Petersen A, Cistero-Bahima A, Enrique E et al. Recombinant lipid transfer protein Cor a 8 from hazelnut: a new tool for in vitro diagnosis of potentially severe hazelnut allergy. J Allergy Clin Immunol 2004; 113(1):141–147.

    Article  PubMed  CAS  Google Scholar 

  68. Steckelbroeck S, Ballmer-Weber BK, Vieths S. Potential, pitfalls, and prospects of food alergy diagnostics using recombinant allergens or synthetic sequential epitopes. J Allergy Clin Immunol 2008;121(6):1323–1330.

    Article  PubMed  CAS  Google Scholar 

  69. Augustin MT, Kokkonen J, Karttunen R, Karttunen TJ. Serum granzymes and CD30 are increased in children's milk protein sensitive enteropathy and celiac disease. J Allergy Clin Immunol 2005; 115(1):157–162.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer

About this chapter

Cite this chapter

Sicherer, S.H. (2009). Food Allergy: Diagnosis of Food Allergy. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Diagnosis and Health Economics. Allergy Frontiers, vol 4. Springer, Tokyo. https://doi.org/10.1007/978-4-431-98349-1_21

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-98349-1_21

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-98293-7

  • Online ISBN: 978-4-431-98349-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics