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Pearls and Pitfalls in Diagnosing IgE-Mediated Food Allergy

  • Food Allergy (T Green, Section Editor)
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Abstract

The term “food allergy” is used by many patients and clinicians to describe a range of symptoms that occur after ingestion of specific foods. However, not all symptoms occurring after food exposure are due to an allergic, or immunologic, response. It is important to properly evaluate and diagnose immunoglobulin E (IgE)-mediated food allergy as this results in reproducible, immediate onset, allergic reactions that can progress toward life-threatening anaphylaxis. Proper diagnosis requires understanding of the common foods that cause these reactions in addition to key historical elements such as symptoms, timing and duration of reaction, and risk factors that may predispose to development of IgE-mediated food allergy. Diagnostic testing for food-specific IgE can greatly aid the diagnosis. However, false-positive test results are very common and can lead to overinterpretation, misdiagnosis, and unnecessary dietary elimination. This review discusses important aspects to consider during evaluation of a patient for suspected IgE-mediated food allergy.

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Abbreviations

BAT:

Basophil activation test

CRD:

Component resolved diagnostics

DBPCOFC:

Double-blind, placebo-controlled oral food challenge

ELISA:

Enzyme-linked immunosorbent assay

EoE:

Eosinophilic esophagitis

FPIES:

Food protein induced enterocolitis syndrome

Ig:

Immunoglobulin

OFC:

Oral food challenge

PPV:

Positive predictive value

RAST:

Radioallergosorbent test

sIgE:

Specific Immunoglobulin E

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol. 2014;134:1016–25 e43. Most recent practice parameter contains extensive evidence-based discussion of all aspects of food allergy diagnosis and management, along with extensive reference list. Includes summary statements to help navigation through the documen.

    Article  PubMed  Google Scholar 

  2. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126:S1–58.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Coon ER, Quinonez RA, Moyer VA, Schroeder AR. Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics. 2014;134:1013–23.

    Article  PubMed  Google Scholar 

  4. Verrill L, Bruns R, Luccioli S. Prevalence of self reported food allergy in US adults: 2001, 2006, and 2010. Allergy Asthma Proc. 2015;36(6):458–67.

  5. Rentzos G, Johanson L, Sjolander S, Telemo E, Ekerljung L. Self-reported adverse reactions and IgE sensitization to common foods in adults with asthma. Clin Transl Allergy. 2015;5:25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Gupta RS, Springston EE, Smith B, Pongracic J, Holl JL, Warrier MR. Parent report of physician diagnosis in pediatric food allergy. J Allergy Clin Immunol. 2013;131:150–6. Large survey of U.S. households identifying data regarding food allergy prevalence and methods used in diagnosis.

    Article  PubMed  Google Scholar 

  7. Boye JI. Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates. Clin Transl Allergy. 2012;2:25.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120:638–46.

    Article  PubMed  Google Scholar 

  9. Turnbull JL, Adams HN, Gorard DA. Review article: the diagnosis and management of food allergy and food intolerances. Aliment Pharmacol Ther. 2015;41:3–25. In depth up-to-date review of various types of food intolerance, including presentation, diagnosis, and management.

    Article  CAS  PubMed  Google Scholar 

  10. Chafen JJ, Newberry SJ, Riedl MA, Bravata DM, Maglione M, Suttorp MJ, et al. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010;303:1848–56.

    Article  PubMed  Google Scholar 

  11. Cox L, Williams B, Sicherer S, Oppenheimer J, Sher L, Hamilton R, et al. Pearls and pitfalls of allergy diagnostic testing: report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force. Ann Allergy Asthma Immunol. 2008;101:580–92.

    Article  PubMed  Google Scholar 

  12. Nowak-Wegrzyn A, Katz Y, Mehr SS, Koletzko S. Non-IgE-mediated gastrointestinal food allergy. J Allergy Clin Immunol. 2015;135:1114–24. Thorough up-to-date review of non-IgE mediated food allergy, including food protein induced enterocolitis syndrome, food protein induced allergic proctocolitis, and food protein induced enteropathy.

    Article  CAS  PubMed  Google Scholar 

  13. Berin MC. Immunopathophysiology of food protein-induced enterocolitis syndrome. J Allergy Clin Immunol. 2015;135:1108–13. Review of pathophysiology and clinical experience from multinational centers treating FPIES.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3–20. e6; quiz 1-2.

    Article  PubMed  Google Scholar 

  15. Furuta GT, Katzka DA. Eosinophilic Esophagitis. N Engl J Med. 2015;373:1640–8. Up-to-date review of pathophysiology, diagnosis, and management of eosinophilic esophagitis in children and adults.

    Article  CAS  PubMed  Google Scholar 

  16. Ho MH, Wong WH, Chang C. Clinical spectrum of food allergies: a comprehensive review. Clin Rev Allergy Immunol. 2014;46:225–40.

    Article  CAS  PubMed  Google Scholar 

  17. Bergmann MM, Caubet JC, Boguniewicz M, Eigenmann PA. Evaluation of food allergy in patients with atopic dermatitis. J Allergy Clin Immunol Pract. 2013;1:22–8. Review article detailing which patients with atopic dermatitis may have food allergy contributing to their disease. Authors discuss diagnosis, interpretation of test results, and management.

    Article  PubMed  Google Scholar 

  18. Fasano A, Catassi C. Clinical practice. Celiac disease. N Engl J Med. 2012;367:2419–26. Excellent review of celiac disease, including differential diagnosis and differences between celiac, non-celiac gluten sensitivity, and wheat allergy.

    Article  CAS  PubMed  Google Scholar 

  19. Biesiekierski JR, Muir JG, Gibson PR. Is gluten a cause of gastrointestinal symptoms in people without celiac disease? Curr Allergy Asthma Rep. 2013;13:631–8.

    Article  CAS  PubMed  Google Scholar 

  20. Sicherer SH, Sampson HA. Food allergy. J Allergy Clin Immunol. 2010;125:S116–25.

    Article  PubMed  Google Scholar 

  21. Simons FE, Ardusso LR, Bilo MB, Dimov V, Ebisawa M, El-Gamal YM, et al. 2012 Update: World Allergy Organization Guidelines for the assessment and management of anaphylaxis. Curr Opin Allergy Clin Immunol. 2012;12:389–99.

    Article  PubMed  Google Scholar 

  22. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011;128:e9–17.

    Article  PubMed  Google Scholar 

  23. Dyer AA, Gupta R. Epidemiology of childhood food allergy. Pediatr Ann. 2013;42:91–5.

    Article  PubMed  Google Scholar 

  24. Osborne NJ, Koplin JJ, Martin PE, Gurrin LC, Lowe AJ, Matheson MC, et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011;127:668–76. e1-2.

    Article  CAS  PubMed  Google Scholar 

  25. Lopata AL, O’Hehir RE, Lehrer SB. Shellfish allergy. Clin Exp Allergy. 2010;40:850–8.

    Article  CAS  PubMed  Google Scholar 

  26. Wilson BG, Bahna SL. Adverse reactions to food additives. Ann Allergy Asthma Immunol. 2005;95:499–507. quiz , 70.

    Article  PubMed  Google Scholar 

  27. Chen JL, Bahna SL. Spice allergy. Ann Allergy Asthma Immunol. 2011;107:191–9. quiz 9, 265.

    Article  CAS  PubMed  Google Scholar 

  28. Kim JS, Sicherer SH. Living with food allergy: allergen avoidance. Pediatr Clin North Am. 2011;58:459–70. xi.

    Article  PubMed  Google Scholar 

  29. Wang J. Management of the patient with multiple food allergies. Curr Allergy Asthma Rep. 2010;10:271–7.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Caubet JC, Eigenmann PA. Allergic triggers in atopic dermatitis. Immunol Allergy Clin North Am. 2010;30:289–307.

    Article  PubMed  Google Scholar 

  31. Clark AT, Ewan PW. The development and progression of allergy to multiple nuts at different ages. Pediatr Allergy Immunol. 2005;16:507–11.

    Article  PubMed  Google Scholar 

  32. Leung PS, Chow WK, Duffey S, Kwan HS, Gershwin ME, Chu KH. IgE reactivity against a cross-reactive allergen in crustacea and mollusca: evidence for tropomyosin as the common allergen. J Allergy Clin Immunol. 1996;98:954–61.

    Article  CAS  PubMed  Google Scholar 

  33. Kazatsky AM, Wood RA. Classification of food allergens and cross-reactivity. Curr Allergy Asthma Rep. 2016;16:22.

    Article  PubMed  Google Scholar 

  34. Siracusa MC, Kim BS, Spergel JM, Artis D. Basophils and allergic inflammation. J Allergy Clin Immunol. 2013;132:789–801. quiz 788.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Bauer RN, Manohar M, Singh AM, Jay DC, Nadeau KC. The future of biologics: applications for food allergy. J Allergy Clin Immunol. 2015;135:312–23. Up-to-date review of immunologic pathogenesis underlying food allergy development, along with attempts to modulate through immunotherapy.

    Article  PubMed  Google Scholar 

  36. Lieberman JA, Chehade M. Use of omalizumab in the treatment of food allergy and anaphylaxis. Curr Allergy Asthma Rep. 2013;13:78–84.

    Article  CAS  PubMed  Google Scholar 

  37. Sampson HA. Food allergy. Part 1: immunopathogenesis and clinical disorders. J Allergy Clin Immunol. 1999;103:717–28.

    Article  CAS  PubMed  Google Scholar 

  38. Vickery BP, Chin S, Burks AW. Pathophysiology of food allergy. Pediatr Clin North Am. 2011;58:363–76. ix-x.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Bird JA, Lack G, Perry TT. Clinical management of food allergy. J Allergy Clin Immunol Pract. 2015;3:1–11. quiz 2.

    Article  PubMed  Google Scholar 

  40. Burks W. Skin manifestations of food allergy. Pediatrics. 2003;111:1617–24.

    PubMed  Google Scholar 

  41. Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson Jr NF, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117:391–7.

    Article  PubMed  Google Scholar 

  42. Perry TT, Matsui EC, Conover-Walker MK, Wood RA. Risk of oral food challenges. J Allergy Clin Immunol. 2004;114:1164–8.

    Article  PubMed  Google Scholar 

  43. Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J. 2015;8:32. In-depth review of presenting features, diagnosis, and treatment of anaphylaxis.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Simons FE. Anaphylaxis. J Allergy Clin Immunol. 2010;125:S161–81.

    Article  PubMed  Google Scholar 

  45. Webb LM, Lieberman P. Anaphylaxis: a review of 601 cases. Ann Allergy Asthma Immunol. 2006;97:39–43.

    Article  PubMed  Google Scholar 

  46. Sampson HA. Food allergy. Part 2: diagnosis and management. J Allergy Clin Immunol. 1999;103:981–9.

    Article  CAS  PubMed  Google Scholar 

  47. Tole JW, Lieberman P. Biphasic anaphylaxis: review of incidence, clinical predictors, and observation recommendations. Immunol Allergy Clin North Am. 2007;27:309–26. viii.

    Article  PubMed  Google Scholar 

  48. Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014;133:1270–7. Provides thorough discussion and extensive evidence-based recommendations regarding the diagnosis, differential diagnosis, prognosis, evaluation, and treatment of urticaria.

    Article  PubMed  Google Scholar 

  49. Perry TT, Conover-Walker MK, Pomes A, Chapman MD, Wood RA. Distribution of peanut allergen in the environment. J Allergy Clin Immunol. 2004;113:973–6.

    Article  CAS  PubMed  Google Scholar 

  50. Simonte SJ, Ma S, Mofidi S, Sicherer SH. Relevance of casual contact with peanut butter in children with peanut allergy. J Allergy Clin Immunol. 2003;112:180–2.

    Article  PubMed  Google Scholar 

  51. Leonardi S, Pecoraro R, Filippelli M, Miraglia Del Giudice M, Marseglia G, Salpietro C, et al. Allergic reactions to foods by inhalation in children. Allergy Asthma Proc. 2014;35:288–94. Article focusing inhalational food allergy reactions in children including risk factors within the child and type and preparation of food associated with such reactions.

    Article  PubMed  Google Scholar 

  52. Sharp MF, Lopata AL. Fish allergy: in review. Clin Rev Allergy Immunol. 2014;46:258–71.

    Article  CAS  PubMed  Google Scholar 

  53. Simons FE, Ardusso LR, Bilo MB, Cardona V, Ebisawa M, El-Gamal YM, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014;7:9.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Ko BS, Kim WY, Ryoo SM, Ahn S, Sohn CH, Seo DW, et al. Biphasic reactions in patients with anaphylaxis treated with corticosteroids. Ann Allergy Asthma Immunol. 2015;115:312–6. A large, retrospective study describing risk factors associated with development of biphasic anaphylaxis.

    Article  CAS  PubMed  Google Scholar 

  55. Lieberman P. Biphasic anaphylactic reactions. Ann Allergy Asthma Immunol. 2005;95:217–26. quiz 26, 58.

    Article  PubMed  Google Scholar 

  56. Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G. Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis. Ann Allergy Asthma Immunol. 2015;115:217–23. e2.

    Article  PubMed  Google Scholar 

  57. Nguyen TA, Leonard SA, Eichenfield LF. An update on pediatric atopic dermatitis and food allergies. J Pediatr. 2015;167:752–6.

    Article  PubMed  Google Scholar 

  58. Lieberman JA, Sicherer SH. Diagnosis of food allergy: epicutaneous skin tests, in vitro tests, and oral food challenge. Curr Allergy Asthma Rep. 2011;11:58–64.

    Article  PubMed  Google Scholar 

  59. Bernstein IL, Li JT, Bernstein DI, Hamilton R, Spector SL, Tan R, et al. Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008;100:S1–148.

    Article  CAS  Google Scholar 

  60. Edwards KP, Martinez BA. Atopy patch testing for foods: a review of the literature. Allergy Asthma Proc. 2014;35:435–43.

    Article  PubMed  Google Scholar 

  61. Isolauri E, Turjanmaa K. Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. J Allergy Clin Immunol. 1996;97:9–15.

    Article  CAS  PubMed  Google Scholar 

  62. Mehl A, Rolinck-Werninghaus C, Staden U, Verstege A, Wahn U, Beyer K, et al. The atopy patch test in the diagnostic workup of suspected food-related symptoms in children. J Allergy Clin Immunol. 2006;118:923–9.

    Article  PubMed  Google Scholar 

  63. Bird JA, Crain M, Varshney P. Food allergen panel testing often results in misdiagnosis of food allergy. J Pediatr. 2015;166:97–100. Must read for anyone who favors food allergen panel testing. This retrospective review characterizes the high rates of misdiagnosis, unnecessary dietary avoidance, and economic burden associated with use of food serum IgE panels.

    Article  PubMed  Google Scholar 

  64. Chokshi NY, Sicherer SH. Interpreting IgE sensitization tests in food allergy. Expert Rev Clin Immunol 2015:1–15. doi:10.1586/1744666X.2016.1124761. Detailed up-to-date discussion of interpretation of IgE testing in the evaluatiojn of food allergy.

  65. Soares-Weiser K, Takwoingi Y, Panesar SS, Muraro A, Werfel T, Hoffmann-Sommergruber K, et al. The diagnosis of food allergy: a systematic review and meta-analysis. Allergy. 2014;69:76–86.

    Article  CAS  PubMed  Google Scholar 

  66. Wood RA, Sicherer SH, Vickery BP, Jones SM, Liu AH, Fleischer DM, et al. The natural history of milk allergy in an observational cohort. J Allergy Clin Immunol. 2013;131:805–12. Observational cohort of infants with milk allergy who were followed long term to identify prognosis, baseline characteristics and immunologic parameters associated with resolution of milk allergy.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. 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 Allergy. 2000;30:1540–6.

    Article  CAS  PubMed  Google Scholar 

  68. Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol. 2001;107:891–6.

    Article  CAS  PubMed  Google Scholar 

  69. Garcia-Ara C, Boyano-Martinez T, Diaz-Pena JM, Martin-Munoz F, Reche-Frutos M, Martin-Esteban M. Specific IgE levels in the diagnosis of immediate hypersensitivity to cows’ milk protein in the infant. J Allergy Clin Immunol. 2001;107:185–90.

    Article  CAS  PubMed  Google Scholar 

  70. Clark AT, Ewan PW. Interpretation of tests for nut allergy in one thousand patients, in relation to allergy or tolerance. Clin Exp Allergy. 2003;33:1041–5.

    Article  CAS  PubMed  Google Scholar 

  71. Celik-Bilgili S, Mehl A, Verstege A, Staden U, Nocon M, Beyer K, et al. The predictive value of specific immunoglobulin E levels in serum for the outcome of oral food challenges. Clin Exp Allergy. 2005;35:268–73.

    Article  CAS  PubMed  Google Scholar 

  72. Kattan JD, Sicherer SH. Optimizing the diagnosis of food allergy. Immunol Allergy Clin North Am. 2015;35:61–76.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133:291–307. quiz 8.

    Article  CAS  PubMed  Google Scholar 

  74. Calvani M, Berti I, Fiocchi A, Galli E, Giorgio V, Martelli A, et al. Oral food challenge: safety, adherence to guidelines and predictive value of skin prick testing. Pediatr Allergy Immunol. 2012;23:755–61.

    Article  PubMed  Google Scholar 

  75. Beyer K, Teuber SS. Food allergy diagnostics: scientific and unproven procedures. Curr Opin Allergy Clin Immunol. 2005;5:261–6.

    Article  CAS  PubMed  Google Scholar 

  76. Wood RA. The likelihood of remission of food allergy in children: when is the optimal time for challenge? Curr Allergy Asthma Rep. 2012;12:42–7.

    Article  PubMed  Google Scholar 

  77. Nowak-Wegrzyn A, Assa’ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS. Work Group report: oral food challenge testing. J Allergy Clin Immunol. 2009;123:S365–83.

    Article  PubMed  Google Scholar 

  78. Caffarelli C, Petroccione T. False-negative food challenges in children with suspected food allergy. Lancet. 2001;358:1871–2.

    Article  CAS  PubMed  Google Scholar 

  79. Skolnick HS, Conover-Walker MK, Koerner CB, Sampson HA, Burks W, Wood RA. The natural history of peanut allergy. J Allergy Clin Immunol. 2001;107:367–74.

    Article  CAS  PubMed  Google Scholar 

  80. Peters RL, Dharmage SC, Gurrin LC, Koplin JJ, Ponsonby AL, Lowe AJ, et al. The natural history and clinical predictors of egg allergy in the first 2 years of life: a prospective, population-based cohort study. J Allergy Clin Immunol. 2014;133:485–91.

    Article  CAS  PubMed  Google Scholar 

  81. Schussler E, Kattan J. Allergen component testing in the diagnosis of food allergy. Curr Allergy Asthma Rep. 2015;15:55. Up-to-date in depth review addressing current understanding and utility of performing component testing for evaluation of food allergy.

    Article  PubMed  Google Scholar 

  82. Bartnikas LM, Sheehan WJ, Larabee KS, Petty C, Schneider LC, Phipatanakul W. Ovomucoid is not superior to egg white testing in predicting tolerance to baked egg. J Allergy Clin Immunol Pract. 2013;1:354–60.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Wal JM. Bovine milk allergenicity. Ann Allergy Asthma Immunol. 2004;93:S2–11.

    Article  CAS  PubMed  Google Scholar 

  84. Dang TD, Tang M, Choo S, Licciardi PV, Koplin JJ, Martin PE, et al. Increasing the accuracy of peanut allergy diagnosis by using Ara h 2. J Allergy Clin Immunol. 2012;129:1056–63.

    Article  CAS  PubMed  Google Scholar 

  85. Berneder M, Bublin M, Hoffmann-Sommergruber K, Hawranek T, Lang R. Allergen chip diagnosis for soy-allergic patients: Gly m 4 as a marker for severe food-allergic reactions to soy. Int Arch Allergy Immunol. 2013;161:229–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Tuano KS, Davis CM. Utility of component-resolved diagnostics in food allergy. Curr Allergy Asthma Rep. 2015;15:32. Review of component testing for food allergy, including limitations of interpretation of results in certain age and geographic populations.

    Article  PubMed  Google Scholar 

  87. Hoffmann-Sommergruber K, Pfeifer S, Bublin M. Applications of molecular diagnostic testing in food allergy. Curr Allergy Asthma Rep. 2015;15:56.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Glaumann S, Nopp A, Johansson SG, Rudengren M, Borres MP, Nilsson C. Basophil allergen threshold sensitivity, CD-sens, IgE-sensitization and DBPCFC in peanut-sensitized children. Allergy. 2012;67:242–7.

    Article  CAS  PubMed  Google Scholar 

  89. Song Y, Wang J, Leung N, Wang LX, Lisann L, Sicherer SH, et al. Correlations between basophil activation, allergen-specific IgE with outcome and severity of oral food challenges. Ann Allergy Asthma Immunol. 2015;114:319–26. One of the largest studies to date evaluating the utility of basophil activation testing versus traditional skin prick or serum IgE testing in the evaluation of food allergy.

    Article  CAS  PubMed  Google Scholar 

  90. Santos AF, Du Toit G, Douiri A, Radulovic S, Stephens A, Turcanu V, et al. Distinct parameters of the basophil activation test reflect the severity and threshold of allergic reactions to peanut. J Allergy Clin Immunol. 2015;135:179–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Mullin GE, Swift KM, Lipski L, Turnbull LK, Rampertab SD. Testing for food reactions: the good, the bad, and the ugly. Nutr Clin Pract. 2010;25:192–8.

    Article  PubMed  Google Scholar 

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  1. Department of Pediatrics, Section of Allergy and Immunology, Nationwide Children’s Hospital and The Ohio State University College of Medicine, 700 Children’s Drive, Columbus, Ohio, 43205, USA

    David R. Stukus & Irene Mikhail

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  1. David R. Stukus
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Stukus, D.R., Mikhail, I. Pearls and Pitfalls in Diagnosing IgE-Mediated Food Allergy. Curr Allergy Asthma Rep 16, 34 (2016). https://doi.org/10.1007/s11882-016-0611-z

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