Summary Statement 10: Determine whether the reported history of food allergy, which often proves inaccurate, and laboratory data are sufficient to diagnose food allergy or whether an oral food challenge (OFC) is necessary.
Summary Statement 25: The clinician should consider OFCs to aid in the diagnosis of IgE-mediated food allergy.
Patient take away points:
An oral food challenge (OFC) is a medically supervised graded feeding of the implicated food allergen. The challenge can be done openly or with blinding where doctor and patient are not certain if they are getting the food or a placebo. The decision to conduct an OFC should be determined by both the patient’s history of clinical reactivity and specific IgE skin and/or blood testing. In many cases, OFC is not prudent or necessary if the patient has an unequivocal, convincing history and testing. However, OFCs can be used to determine clinical reactivity when the history is uncertain and results of specific IgE testing are negative or equivocal. For example, if a child has hives within 30 minutes of eating at a buffet and skin and blood testing shows several positives, an OFC would be tremendously useful to identify the real trigger. Due to the risk of life-threatening symptoms or anaphylaxis, OFC should always be conducted under the supervision of trained medical staff in a health care facility equipped to treat anaphylaxis.
- 03 May 2015