Skip to main content
Log in

Food allergy in children

  • Symposium on Pediatric Allergy-I
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Food allergies are increasing in prevalence and as a disease burden throughout the world, however they seem to increasingly affect countries with a formerly low prevalence. Consideration and diagnosis of food allergies are important as it has ramifications that affect a child’s diet, care at school and home and is recognised to be associated with anxiety of parents, family and care takers. Food allergies vary significantly between countries, however nut allergies appear to be widely associated with serious reactions and death. The value of specific food immunoglobulin E (IgE) and skin prick tests (SPT) has been extensively analysed in children in recent years and can provide very useful information in an appropriately selected population. Diagnosis may require formal challenges to confirm a genuine allergic reaction condition rather than an intolerance reaction due to other mechanisms. The medical care of a food allergic child requires concurrent dietary advice and management, risk avoidance and emergency management plans. Reintroduction of foods occurs when the risk profile is appropriate based mainly on the predictive information obtained by SPTs and specific IgE levels. Fortunately allergies to egg and milk resolve by 3–5 years in about 80% of children. There have been some recent advances in immunotherapeutic approaches to food allergy although this has not translated to success in human treatment to date.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Jarvis D, Burney P. ABC of allergies. The epidemiology of allergic disease.BMJ 1998; 316: 607–610.

    PubMed  CAS  Google Scholar 

  2. Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods.J Allerg Clin Immunol 2001; 107: 191–193.

    Article  CAS  Google Scholar 

  3. Primeau MN, Kagan R, Joseph L, Lim H, Dufresne Cet al. The psychological burden of peanut allergy as perceived by adults with peanut allergy and the parents of peanut-allergic children.Clin Exp Allergy 2000; 30: 1135–1143.

    Article  PubMed  CAS  Google Scholar 

  4. Ewan PW, Clark AT. Long-term prospective observational study of patients with peanut and nut allergy after participation in a management plan.Lancet 2001; 357: 111–115.

    Article  PubMed  CAS  Google Scholar 

  5. Helm RM, Burks AW. Mechanisms of food allergy.Curr Opin Immunol 2000; 12: 6647–6653.

    Article  Google Scholar 

  6. Howell WM, Standring P, Warner JA, Warner JO. HLA class II genotype, HLA-DR B cell surface expression and allergen specific IgE production in atopic and non-atopic members of asthmatic family pedigrees.Clin Exp Allerg 1999; 29 (Suppl) 4: 35–38.

    CAS  Google Scholar 

  7. Boehncke WH, Loeliger C, Kuehnl P, Kalbacher H, Boten BO, Gall H. Identification of HLA-DR and -DQ alleles conferring susceptibility to pollen allergy and pollen associated food allergy.Clin Exp Allergy 1998; 28: 434–434.

    Article  PubMed  CAS  Google Scholar 

  8. Hourihane JO, Dean TP, Warner JO. Peanut allergy in relation to heredity, maternal diet, and other atopic diseases: results of a questionnaire survey, skin prick testing and food challenges.BMJ 1996; 313: 518–521.

    PubMed  CAS  Google Scholar 

  9. Sicherer SH, Furlong TJ, Maes HH, Desnick RJ, Sampson HA, Gelb BD. Genetics of peanut allergy: a twin study.J Allerlg Clin Immunol 2000; 106: 53–56.

    Article  CAS  Google Scholar 

  10. Jones CA, Kilburn SA, Warner JA, Warner JO. Intrauterine environment and fetal allergic sensitization.Clin Exp Allerg 1998; 28: 655–659.

    Article  CAS  Google Scholar 

  11. Bock SA, Sampson HA, Atkins FM, Zeiger RS, Lehrer S, Sachs Met al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual.J Allerg Clin Immunol 1988; Dec; 82: 986–997.

    Article  CAS  Google Scholar 

  12. Novembre E, Cianferoni A, Bernardini R, Mugnaini L, Caffarelli C, Cavagni Get al. Anaphylaxis in children: clinical and allergologic features.Pediatrics 1998; 101: E8.

    Article  PubMed  CAS  Google Scholar 

  13. Ballmer-Weber BK, Vieths S, Luttkopf D, Heuschmann P, Wuthrich B. Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root.J Allerg Clin Immunol 2000; 106: 373–378.

    Article  CAS  Google Scholar 

  14. Ortolani C, Ballmer-Weber BK, Hansen KS, Ispano M, Wuthrich B, Bindslev-Jensenet al. Hazelnut allergy: a double-blind, placebo-controlled food challenge multicenter study.J Allerg Clin Immunol 2000; 105: 577–581.

    Article  CAS  Google Scholar 

  15. Ballmer-Weber BK, Wuthrich B, Wangorsch A, Fotisch K, Altmann F, Vieths S. Carrot allergy: Double-blinded, placebo-controlled food challenge and identification of allergens.J Allerg Clin Immunol 2001; 108: 301–307.

    Article  CAS  Google Scholar 

  16. Kanny G, Moneret-Vautrin DA, Flabbee J, Beaudouin E, Morisset M, Thevenin F. Population study of food allergy in France.J Allerg Clin Immunol 2001; 108: 133–140.

    Article  CAS  Google Scholar 

  17. Rance F, Dutau G, Abbal M. Mustard allergy in children.Allergy 2000; 55: 496–450.

    Article  PubMed  CAS  Google Scholar 

  18. Levy Y, Danon YL. Allergy to sesame seed in infants.Allergy 2001; 56: 193–194.

    Article  PubMed  CAS  Google Scholar 

  19. Sporik R, Hill D. Allergy to peanut, nuts, and sesame seed in Australian children.BMJ 1996; 313: 1477–1484.

    PubMed  CAS  Google Scholar 

  20. Goh DL, Lau YN, Chew FT, Shek LP, Lee BW. Pattern of food-induced anaphylaxis in children of an Asian community.Allergy 1999; 54: 84–86.

    Article  PubMed  CAS  Google Scholar 

  21. Takahashi Y, Ichikawa S, Aihara Y, Yokota S. Buckwheat allergy in 90,000 school children in Yokohama.Arerugi 1998; 47: 26–33.

    PubMed  CAS  Google Scholar 

  22. Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia: identification and targets for treatment.Ann Med 1999; 31: 272–281.

    PubMed  CAS  Google Scholar 

  23. Beyer K, Morrow E, Li XM, Bardina L, Bannon GA, Burks AWet al. Effects of cooking methods on peanut allergenicity.J Allerg Clin Immunol 2001; 107: 1077–1081.

    Article  CAS  Google Scholar 

  24. Cant AJ, Bailes JA, Marsden RA, Hewitt D. Effect of maternal dietary exclusion on breast fed infants with eczema: two controlled studies.Br Med J (Clin Res Ed) 1986; 2293: 231–233.

    Google Scholar 

  25. Vadas P, Wai Y, Burks W, Perelman B. Detection of peanut allergens in breast milk of lactating women.JAMA 2001; 285: 1746–1748.

    Article  PubMed  CAS  Google Scholar 

  26. Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA. Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey.J Allerg Clin Immunol 1999; 103: 559–562.

    Article  CAS  Google Scholar 

  27. Hourihane JO, Harris H, Langton-Hewer S, Kilburn SA, Warner JO. Clinical features of cashew allergy.Allergy 2001; 56: 252–253.

    Article  PubMed  CAS  Google Scholar 

  28. Pastorello EA, Pravettoni V, Ispano M, Farioli L, Ansaloni R, Rotondo Fet al. Identification of the allergenic components of kiwi fruit and evaluation of their cross-reactivity with timothy and birch pollens.J Allerg Clin Immunol 1996; Sep; 98(3): 601–610.

    Article  CAS  Google Scholar 

  29. Fremont S, Moneret-Vautrin DA, Nicolas JP. Allergenicity of the nan-gai nut.Allergy 2001; 56: 581.

    Article  PubMed  CAS  Google Scholar 

  30. Sicherer SH. Food allergy: when and how to perform oral food challenges.Pediatr Allerg Immunol 1999; 10: 226–234.

    Article  CAS  Google Scholar 

  31. Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life.Pediatrics 1987; 79: 683–688.

    PubMed  CAS  Google Scholar 

  32. Jansen JJ, Kardinaal AF, Huijbers G, Vlieg-Boerstra BJ, Martens BP, Ockhuizen T. Prevalence of food allergy and intolerance in the adult Dutch population.J Allerg Clin Immunol 1994; 93: 446–456.

    Article  CAS  Google Scholar 

  33. Young E, Stoneham MD, Petruckevitch A, Barton J, Rona R. A population study of food intolerance.Lancet 1994; 343: 1127–30.

    Article  PubMed  CAS  Google Scholar 

  34. Hourihane JO, Kilburn SA, Dean P, Warner JO. Clinical characteristics of peanut allerg.Clin Exp Allerg 1997; 27: 634–639.

    Article  CAS  Google Scholar 

  35. Sicherer SH, Burks AW, Sampson HA. Clinical features of acute allergic reactions to peanut and tree nuts in children.Pediatrics 1998; 102: e6.

    Article  PubMed  CAS  Google Scholar 

  36. Sampson HA, Ho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents.J Allerg Clin Immunol 1997; 100: 444–451.

    Article  CAS  Google Scholar 

  37. Eigenmann PA, Sampson HA. Interpreting skin prick tests in the evaluation of food allergy in children.Pediatr Allerg Immunol 1998; 9: 186–191.

    Article  CAS  Google Scholar 

  38. Sporik R, Hill DJ, Hosking CS. Specificity of allergen skin testing in predicting positive open food challenges to milk, egg and peanut in children.Clin Exp Allerg 2000; 30: 1540–1546.

    Article  CAS  Google Scholar 

  39. Hill DJ, Hosking CS, Reyes-Benito LV. Reducing the need for food allergen challenges in young children: a comparison ofin vitro with in vivo tests.Clin Exp Allerg 2001; 31: 1031–1035.

    Article  CAS  Google Scholar 

  40. Kondo N, Shinbara M, Inoue R, Fukao T, Kaneko H, Teramoto Tet al. Inhibition of interferon-gamma production from lymphocytes stimulated with food antigens by a beta 2-agonist, procaterol, in patients with food-sensitive atopic dermatitis.J Investig Allergol Clin Immunol 1997; 7: 225–228.

    PubMed  CAS  Google Scholar 

  41. Vanto T, Juntunen-Backman K, Kalimo K, Klemola T, Koivikko A, Koskinen Pet al. The patch test, skin prick test, and serum milk-specific IgE as diagnostic tools in cow’s milk allergy in infants.Allergy 1999; 54: 837–842.

    Article  PubMed  CAS  Google Scholar 

  42. Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents.N Engl J Med 1992; 327: 380–384.

    Article  PubMed  CAS  Google Scholar 

  43. Yocum MW, Butterfield JH, Klein JS, Volcheck GW, Schroeder DR, Silverstein MD. Epidemiology of anaphylaxis in Olmsted County: A population-based study.J Allerg Clin Immunol 1999; 104: 452–456.

    Article  CAS  Google Scholar 

  44. Pumphrey RS, Stanworth SJ. The clinical spectrum of anaphylaxis in north-west England.Clin Exp Allerg 1996; 26: 1364–1370.

    Article  CAS  Google Scholar 

  45. Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions.Clin Exp Allerg 2000; 30: 1144–1150.

    Article  CAS  Google Scholar 

  46. Vander Leek TK, Liu AH, Stefanski K, Blacker B, Bock SA. The natural history of peanut allergy in young children and its association with serum peanut-specific IgE.J Pediatr 2000; 137: 749–55.

    Article  Google Scholar 

  47. Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY. Treatment of peanut allergy with rush immunotherapy.J Allerg Clin Immunol 1992; 90: 256–262.

    Article  CAS  Google Scholar 

  48. Nelson HS, Lahr J, Rule R, Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract.J Allerg Clin Immunol 1997; 99: 744–751.

    Article  CAS  Google Scholar 

  49. Sabbah A. Specific immunotherapy using allergens apropos of specific immunotherapy by the sublingual route.Allerg Immunol 1998; 30: 221–228.

    CAS  Google Scholar 

  50. Roy K, Mao HQ, Huang SK, Leong KW. Oral gene delivery with chitosan-DNA nanoparticles generates immunologic protection in a murine model of peanut allergy.Nat Med 1999; 5: 387–391.

    Article  PubMed  CAS  Google Scholar 

  51. Nguyen MD, Cinman N, Yen J, Horner AA. DNA-based vaccination for the treatment of food allergy.Allergy 2001; 56 S67: 127–130.

    Article  PubMed  Google Scholar 

  52. Burks W, Bannon G, Lehrer SB. Classic specific immunotherapy and new perspectives in specific immunotherapy for food allergy.Allergy 2001; 56 S67: 121–124.

    Article  PubMed  Google Scholar 

  53. Li X, Huang CK, Schofield BH, Burks AW, Bannon GA, Kim KHet al. Strain-dependent induction of allergic sensirizarion caused by peanut allergen DNA immunization in mice.J Immunol 1999; 162: 3045–3052.

    PubMed  CAS  Google Scholar 

  54. Vickers DW, Maynard L, Ewan PW. Management of children with potential anaphylactic reactions in the community: a training package and proposal for good practice.Clin Exp Allerg 1997; 27: 898–903.

    Article  CAS  Google Scholar 

  55. Hill DJ, Heine RG, Hosking CS. Management of peanut and nut allergies.Lancet 2001; 357: 87–88.

    Article  PubMed  CAS  Google Scholar 

  56. Sicherer SH, Forman JA, Noone SA. Use assessment of self-administered epinephrine among food-allergic children and pediatricians.Pediatrics 2000; 105: 359–362.

    Article  PubMed  CAS  Google Scholar 

  57. Gold MS, Sainsbury R. First aid anaphylaxis management in children who were prescribed an epinephrine autoinjector device (EpiPen).J Allerg Clin Immunol 2000; 106: 171–176.

    Article  CAS  Google Scholar 

  58. Bernhisel-Broadbent J, Sampson HA. Cross-allergenicity in the legume botanical family in children with food hypersensitivity.J Allerg Clin Immunol 1989; 83: 435–440.

    Article  CAS  Google Scholar 

  59. Ewan PW. Clinical study of peanut and nut allergy in 62 consecutive patients: new features and associations.BMJ 1996; 312: 1074–1078.

    PubMed  CAS  Google Scholar 

  60. Keating MU, Jones RT, Worley NJ, Shively CA, Yunginger JW. Immunoassay of peanut allergens in food-processing materials and finished foods.J Allerg Clin Immunol 1990; 86: 41–44.

    Article  CAS  Google Scholar 

  61. American Academy of Pediatrics Hypoallergenic Infant Formulas.Pediatrics 2000; 106 : 346-9 : http://www.aap.org/ policy/re0005.html

  62. Hill DJ, Cameron DJ, Francis DEet al. Challenge confirmation of late-onset reactions to extensively hydrolyzed formulas in infants with multiple food protein intolerance.J Allerg Clin Immunol 1995; 96: 386–394.

    Article  CAS  Google Scholar 

  63. McLeish CM, MacDonald A, Booth IW. Comparison of an elemental with a hydrolysed whey formula in intolerance to cows’ milk.Arch Dis Child 1995; 73: 211–225.

    Article  PubMed  CAS  Google Scholar 

  64. Halken S, Host A. How hypoallergenic are hypoallergenic cow’s milk-based formulas.Allergy 1997; 52: 1175–1183.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Strobel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hourihane, J.O., Smith, P.K. & Strobel, S. Food allergy in children. Indian J Pediatr 69, 61–67 (2002). https://doi.org/10.1007/BF02723779

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02723779

Key words

Navigation