PMID- 15575939
OWN - NLM
STAT- MEDLINE
DCOM- 20050405
LR  - 20101118
IS  - 0105-4538 (Print)
IS  - 0105-4538 (Linking)
VI  - 60
IP  - 1
DP  - 2005 Jan
TI  - Diagnostic pitfalls in food allergy in children.
PG  - 104-7
AB  - Currently, the diagnostic work-up of suspected food allergy includes skin prick 
      tests, the measurement of food specific immunoglobulin E (IgE), and the atopy 
      patch test, and double-blind, placebo-controlled food challenges. However, all of 
      these methods, even double-blind, placebo-controlled food challenges (DBPCFC), 
      may sometimes be misleading. This overview describes several pitfalls for 
      standard diagnostic methods such as problems with irritative skin reactions 
      mimicking IgE-mediated symptoms, the problem of non-IgE-mediated reactions, 
      pitfalls arising from the way foods are prepared or processed, effects of the 
      route of exposure, the role of augmentation factors lowering the threshold value 
      for clinical reactions, the noncomparability of specific IgE decision points, the 
      influence of the timing of diagnostic measures. In addition, the problem of 
      alternative diagnostic measures is discussed. In conclusion, there are several 
      pitfalls in the diagnostic work-up of food allergy, which may be misleading for 
      the physician. Properly performed controlled oral food challenges still represent 
      the gold standard for implementing specific diets in food allergic individuals in 
      order to avoid both unjustified diets, which may lead to severe impairments in 
      growth and development, and to avoid unnecessary symptoms if an underlying food 
      allergy is not correctly identified as a cause for the symptoms of the patient.
FAU - Niggemann, B
AU  - Niggemann B
AD  - Department of Pediatric Pneumology and Immunology, University Children's Hospital 
      Charite of Humboldt University, Berlin, Germany.
FAU - Beyer, K
AU  - Beyer K
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Child
MH  - Cooking
MH  - Diagnosis, Differential
MH  - False Negative Reactions
MH  - Food Hypersensitivity/*diagnosis/immunology
MH  - Humans
MH  - Immunoglobulin E/immunology
MH  - Skin Diseases/diagnosis
MH  - Time Factors
EDAT- 2004/12/04 09:00
MHDA- 2005/04/06 09:00
CRDT- 2004/12/04 09:00
PHST- 2004/12/04 09:00 [pubmed]
PHST- 2005/04/06 09:00 [medline]
PHST- 2004/12/04 09:00 [entrez]
AID - ALL591 [pii]
AID - 10.1111/j.1398-9995.2004.00591.x [doi]
PST - ppublish
SO  - Allergy. 2005 Jan;60(1):104-7. doi: 10.1111/j.1398-9995.2004.00591.x.