EAACI guidelines on the diagnosis of IgE-mediated food allergy.

Publication

EAACI guidelines on the diagnosis of IgE-mediated food allergy.

Journal Paper/Review - Oct 10, 2023

Santos Alexandra, Riggioni Carmen, Agache Ioana Octavia, Akdis Cezmi A, Akdis Mübeccel, Alvarez-Perea Alberto, Alvaro-Lozano Montserrat, Ballmer-Weber Barbara, Barni Simona, Beyer Kirsten, Bindslev-Jensen Carsten, Brough Helen Annaruth, Buyuktiryaki Betul, Chu Derek, Del Giacco Stefano, Dunn Galvin Audrey, Eberlein Bernadette, Ebisawa Motohiro, Eigenmann Philippe, Eiwegger Thomas, Feeney Mary, Fernández-Rivas Montserrat, Fisher Helen R, Fleischer David M, Giovannini Mattia, Gray Claudia, Hoffmann-Sommergruber Karin, Halken Susanne, Hourihane Jonathan O'B, Jones Christina J, Jutel Marek, Knol Edward, Konstantinou George N, Lack Gideon, Lau Susanne, Marques Mejias Andreina, Marchisotto Mary Jane, Meyer Rosan, Mortz Charlotte G, Moya Beatriz, Muraro Antonella, Nilsson Caroline, Lopes de Oliveira Lucila Camargo, O'Mahony Liam, Papadopoulos Nikolaos G, Perrett Kirsten, Peters Rachel L, Podestà Marcia, Poulsen Lars K, Roberts Graham, Sampson Hugh A, Schwarze Jürgen, Smith Peter Kenneth, Tham Elizabeth Huiwen, Untersmayr Eva, Van Ree Ronald, Venter Carina, Vickery Brian P, Vlieg-Boerstra Berber, Werfel Thomas, Worm Margitta, du Toit George, Skypala Isabel

Citation

Santos A, Riggioni C, Agache I, Akdis C, Akdis M, Alvarez-Perea A, Alvaro-Lozano M, Ballmer-Weber B, Barni S, Beyer K, Bindslev-Jensen C, Brough H, Buyuktiryaki B, Chu D, Del Giacco S, Dunn Galvin A, Eberlein B, Ebisawa M, Eigenmann P, Eiwegger T, Feeney M, Fernández-Rivas M, Fisher H, Fleischer D, Giovannini M, Gray C, Hoffmann-Sommergruber K, Halken S, Hourihane J, Jones C, Jutel M, Knol E, Konstantinou G, Lack G, Lau S, Marques Mejias A, Marchisotto M, Meyer R, Mortz C, Moya B, Muraro A, Nilsson C, Lopes de Oliveira L, O'Mahony L, Papadopoulos N, Perrett K, Peters R, Podestà M, Poulsen L, Roberts G, Sampson H, Schwarze J, Smith P, Tham E, Untersmayr E, Van Ree R, Venter C, Vickery B, Vlieg-Boerstra B, Werfel T, Worm M, du Toit G, Skypala I. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy 2023; 78:3057-3076.

Type

Journal Paper/Review (English)

Journal

Allergy 2023; 78

Publication Date

Oct 10, 2023

Issn Electronic

1398-9995

Pages

3057-3076

Brief description/objective

This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.