Clinical Spectrum of Food Allergies: a Comprehensive Review

Clinical Reviews in Allergy & Immunology volume 46, pages225–240(2014)Cite this article

Abstract

Food allergy is defined as an adverse immune response towards food proteins or as a form of a food intolerance associated with a hypersensitive immune response. It should also be reproducible by a double-blind placebo-controlled food challenge. Many reported that food reactions are not allergic but are intolerances. Food allergy often presents to clinicians as a symptom complex. This review focuses on the clinical spectrum and manifestations of various forms of food allergies. According to clinical presentations and allergy testing, there are three types of food allergy: IgE mediated, mixed (IgE/Non-IgE), and non-IgE mediated (cellular, delayed type hypersensitivity). Recent advances in food allergy in early childhood have highlighted increasing recognition of a spectrum of delayed-onset non-IgE-mediated manifestation of food allergy. Common presentations of food allergy in infancy including atopic eczema, infantile colic, and gastroesophageal reflux. These clinical observations are frequently associated with food hypersensitivity and respond to dietary elimination. Non-IgE-mediated food allergy includes a wide range of diseases, from atopic dermatitis to food protein-induced enterocolitis and from eosinophilic esophagitis to celiac disease. The most common food allergies in children include milk, egg, soy, wheat, peanut, treenut, fish, and shellfish. Milk and egg allergies are usually outgrown, but peanut and treenut allergy tends to persist. The prevalence of food allergy in infancy is increasing and may affect up to 15–20 % of infants. The alarming rate of increase calls for a public health approach in the prevention and treatment of food allergy in children.

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Affiliations

  1. The Division of Immunology, Rheumatology and Allergy, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

    Marco H.-K. Ho & Wilfred H.-S. Wong

  2. Division of Allergy, and Immunology, Thomas Jefferson University, Nemours Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA

    Christopher Chang

Authors
  1. Marco H.-K. Ho
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  2. Wilfred H.-S. Wong
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  3. Christopher Chang
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Corresponding authors

Correspondence to Marco H.-K. Ho or Christopher Chang.

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Ho, M.HK., Wong, W.HS. & Chang, C. Clinical Spectrum of Food Allergies: a Comprehensive Review. Clinic Rev Allerg Immunol 46, 225–240 (2014). https://doi.org/10.1007/s12016-012-8339-6

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Keywords

  • Food allergy
  • Food protein-induced enterocolitis
  • Eosinophilic esophagitis
  • Oral allergy syndrome
  • Urticarial
  • Anaphylaxis
  • Wheezing
  • Atopic dermatitis