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Food challenge procedure: Optimal choices for clinical practice

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The diagnosis of food allergy depends on thorough medical history-taking that may be supplemented with trials of dietary eliminations, skin testing, and specific IgE antibody measurement. However, the reliability of such procedures is often suboptimal. For most cases, oral challenge testing is needed to confirm the diagnosis of food allergy and to identify the causative food(s). Though blinded challenges are ideal, open challenges can be appropriate in some cases, particularly in young children. An optimal design of the procedure would depend on the age of the patient, the anticipated symptoms, and the provoking food quantity. The test is much safer than many surgical and medical procedures being routinely performed. This article presents a practical guideline that can reliably and safely encourage an increased use of this important test in the diagnosis of food allergy.

Keywords: Allergy; food allergy diagnosis; food challenge procedure; food challenge testing; provocation testing; skin tests; specific IgE

Document Type: Research Article

Affiliations: Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, Louisiana

Publication date: 01 November 2007

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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