The Journal of Allergy and Clinical Immunology
Volume 123, Issue 6, Supplement , Pages S365-S383, June 2009

Work Group report: Oral food challenge testing

  • Anna Nowak-Węgrzyn, MD

      Affiliations

    • Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY
    • ,
  • Amal H. Assa'ad, MD

      Affiliations

    • Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
    • Corresponding Author InformationReprint requests: Amal Assa'ad, MD, Professor of Pediatrics, Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, and Past-Chair, Adverse Reactions to Foods Committee, 3333 Burnet Ave, Cincinnati, OH 45229.
    • Authors listed alphabetically.
    • ,
  • Sami L. Bahna, MD, DrPH

      Affiliations

    • Louisiana State University Health Sciences Center, Shreveport, La
    • Authors listed alphabetically.
    • ,
  • S. Allan Bock, MD

      Affiliations

    • National Jewish Health and University of Colorado Health Sciences Center, Denver, Colo
    • Authors listed alphabetically.
    • ,
  • Scott H. Sicherer, MD

      Affiliations

    • Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY
    • Authors listed alphabetically.
    • ,
  • Suzanne S. Teuber, MD

      Affiliations

    • University of California, Davis, School of Medicine, Davis, Calif
    • Authors listed alphabetically.
    • ,
  • Adverse Reactions to Food Committee of the American Academy of Allergy, Asthma & Immunology

Received 11 August 2008; received in revised form 11 March 2009; accepted 23 March 2009.

Oral food challenges are procedures conducted by allergists/immunologists to make an accurate diagnosis of immediate, and occasionally delayed, adverse reactions to foods. The timing of the challenge is carefully chosen based on the individual patient history and the results of skin prick tests and food specific serum IgE values. The type of the challenge is determined by the history, the age of the patient, and the likelihood of encountering subjective reactions. The food challenge requires preparation of the patient for the procedure and preparation of the office for the organized conduct of the challenge, for a careful assessment of the symptoms and signs and the treatment of reactions. The starting dose, the escalation of the dosing, and the intervals between doses are determined based on experience and the patient's history. The interpretation of the results of the challenge and arragements for follow-up after a challenge are important. A negative oral food challenge result allows introduction of the food into the diet, whereas a positive oral food challenge result provides a sound basis for continued avoidance of the food.

Key words: Oral food challenge, food allergy, food allergens, anaphylaxis, food additives, single-blind, placebo-controlled oral food challenge, double-blind, placebo-controlled oral food challenge, skin prick test, IgE, food protein–induced enterocolitis syndrome, peanut, cow's milk, milk, egg, wheat, tree nuts

Abbreviations used: DBPCFC, Double-blind, placebo-controlled food challenge, OFC, Oral food challenge, SPT, Skin prick test

 

 Supported by the Food Allergy Initiative. The Food Allergy Initiative is a nonprofit corporation dedicated to finding a cure for food allergies by funding food allergy research; it does not conduct scientific research or render medical advice. The opinion in the manuscript reflects that of the authors and not that of the Food Allergy Initiative, and Food Allergy Initiative is not responsible or liable for the information set forth in the manuscript or for any damages that may result from its use.

 Disclosure of potential conflict of interest: A. Assa'ad has received research support from GlaxoSmithKline. A. Nowak-Węgrzyn has received research support from the National Institutes of Health. S. L. Bahna has received research support from Genentech/Novartis and CSL Behring. S. H. Sicherer has received research support from the National Institutes of Health/National Institute of Allergy and Infectious Diseases and is a consultant for the Food Allergy Initiative and a medical advisor for the Food Allergy and Anaphylaxis Network. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(09)00562-4

doi:10.1016/j.jaci.2009.03.042

The Journal of Allergy and Clinical Immunology
Volume 123, Issue 6, Supplement , Pages S365-S383, June 2009

Article Tools

* Image Usage & Resolution