Food allergies challenge tests

Foods can be treated based on in vitro specific IgE level testing (such as Pharmacia Unicap) or challenge testing. Dosage depends on the severity of the food allergy. The more severe food allergies require smaller doses. Antigens are used 3 times daily until tolerance develops. Specific IgE levels are rechecked typically every 6-12 months. Doses are not increased until specific IgE levels start to decline. 

The practical procedure for conducting challenge tests differs from center to center and depends on the experience of authors (Sampson, 1999b Reibel et al., 2000 Bock, 2003 H0st et al., 2003 Bindslev-Jensen et al., 2004 Niggemenn et al., 2005 The Food Allergy and Anaphylaxis Network, 2005) (Table 3.3.12). 

Contraindications food challenges are contraindicated for patients with a history of past or present anaphylactic reaction to a single food or a group of food products ingested and with a simultaneous positive test for specific food (slgE) (The Food Allergy and Anaphylaxis Network, 2005). 

C. A. Bmijnzeel-Koomen, L. S. Taams, E. F. Knol, E. van Hoffen, R. van Ree, and A. C. Knulst. 2004. Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy 34 (5) 761—769. 

Changes in dietary habits and the internationalization of foods have led to the increasingly frequent use of spices. Children with allergy symptoms to spices were evaluated, by prick tests using the basic foodstuff, crushed or diluted in saline, for aniseed, cinnamon, coriander, cumin, curry, fennel, nutmeg, paprika, sesame and vanilla labial and/or challenge tests were performed for... 

Kurek M, Grubska-Suchanek E. Challenge tests with food additives and aspirin in the diagnosis of chronic urticaria. J Allergy Clin Immunol 2001 41 463-9. 

Most food allergies may be clinically identified through double-blind placebo-controlled crossover food challenge studies. However, due to inherent risks involved in such procedures, food allergies are often identified, at least initially, using a variety of tests either alone or in combination. For example, skin prick tests alone or in combination with patient IgE reactivity assays may be nsed for snch... 

Roehr, C.C., Reibel, S., Ziegert, M. et al. 2001. 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 107 548-553. 

Sporik, R., Hill, D.J., and Hosking, C.S. 2000. Specificity of allergen skin testing in predicting positive open food challenges to milk, egg and peanut in children. Clin Exp Allergy 30 1541-1546. 

Verstege, A., A. Mehl, C. Rolinck-Weminghaus, U. Staden, M. Nocon, K. Beyer, and B. Niggemann. 2005. The predictive value of the skin prick test weal size for the outcome of oral food challenges. Clin Exp Allergy 35 (9) 1220-1226. 

Thune P, Granholt A (1975) Provocation tests with antiphlogistic and food additives in recurrent urticaria. Dermatologica 151 360-367 Trautlein JJ, Mann WJ (1978) Anaphylactic shock caused by yellow dye (FD C No. 5 and FD C No. 6) in an enema (case report). Ann Allergy 41 28-29 Vedanthan PK, Menon MM, Bell TD, Bergin D (1977) Aspirin and tartrazine oral challenge incidence of adverse response in chronic childhood asthma. J Allergy Clin Immunol 60 8-13... 

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