Skip to main content
SpringerLink
Log in
Book cover

Pediatric Food Allergy pp 193–201Cite as

Clinical Management of Food Allergy

  • Chapter
  • First Online:

  • 812 Accesses

Abstract

Food allergy has been increasing in prevalence over the last several decades. Currently, there are no approved treatments or cures for food allergy. Accurate diagnosis and appropriate management of food allergies are essential for avoiding potentially life-threatening reactions. Management includes guidance around avoidance of trigger allergens as well as counseling on treatment of acute reactions related to accidental exposures. Advice on cross-contamination and understanding ingredient labeling are imperative. Emergency treatment medications for accidental reactions should be prescribed, and families should be taught how and when to use these medications. An emergency action plan should be given to and reviewed with all patients with food allergies. Nutritional consultation may be required to ensure adequate nutrition and growth. New treatments for food allergy that are currently in development may change practice in the near future.

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

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Gupta RS, Warren CM, Smith BM, Blumenstock JA, Jiang J, Davis MM, Nadeau KC. The public health impact of parent-reported childhood food allergies in the United States. Pediatrics. 2018 Dec;142(6):e20181235.

    PubMed  PubMed Central  Google Scholar 

  2. Jackson KD, Howie LD, Akinbami LJ. Trends in allergic conditions among children: United States, 1997–2011. NCHS Data Brief. 2013;(121):1–8.

    Google Scholar 

  3. Bernstein IL, Storms WW. Practice parameters for allergy diagnostic testing. Joint task force on practice parameters for the diagnosis and treatment of asthma. The American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1995;75:543.

    CAS  PubMed  Google Scholar 

  4. Heinzerling L, Mari A, Bergmann KC, et al. The skin prick test-European standards. Clin Translat Allergy. 2013 Feb 1;3(1):3.

    Google Scholar 

  5. Makhija M. In vivo and in vitro testing in allergy and immunology. In: Grammer LC, Greenberger PA, editors. Patterson’s Allergic Diseases. 8th ed. Philadelphia: Wolters Kruger; 2018.

    Google Scholar 

  6. Sampson HA, Aceves S, Bock SA, et al. Food allergy: a practice parameter update – 2014. J Allergy Clin Immunol. 2014;134(5):1016–24 e43.

    PubMed  Google Scholar 

  7. Macchia D, Melioli G, Pravettoni V, et al. Guidelines for the use and interpretation of diagnostic methods in adult food allergy. Clin Mol Allergy. 2015;3:27.

    Google Scholar 

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

    PubMed  Google Scholar 

  9. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. J Allergy Clin Immunol. 2010;126:1105–18.

    PubMed  PubMed Central  Google Scholar 

  10. Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma and Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol. 2012;130:1260–74.

    PubMed  Google Scholar 

  11. 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.

    PubMed  Google Scholar 

  12. Bird JA, Groetch M, Allen KJ, Bock SA, Leonard S, Nowak-Wegrzyn AH, et al. Conducting an oral food challenge to peanut in an infant. J Allergy Clin Immunol Pract. 2017;5(2):301–11.

    PubMed  Google Scholar 

  13. MacGinnitie AJ, Young MC. The role of food challenges in clinical practice. J Allergy Clin Immunol Pract. 2018;6:353–60.

    PubMed  Google Scholar 

  14. Akuete K, Guffey D, Israelsen RB, Broyles JM, Higgins LJ, Green TD, et al. Multicenter prevalence of anaphylaxis in clinic-based oral food challenges. Ann Allergy Asthma Immunol. 2017 Oct;119(4):339–348.e1.

    PubMed  Google Scholar 

  15. Van der Velde JL, Flokstra-de Blok BM, de Groot H, et al. Food allergy-related quality of life after double-blind, placebo-controlled food challenges in adults, adolescents and children. J Allergy Clin Immunol. 2012;130:1136–1143;e2.

    PubMed  Google Scholar 

  16. Kemp A, Allen CW, Campbell DE. Parental perceptions in egg allergy: does egg challenge make a difference? Pediatr Allergy Immunol. 2009;20:648–53.

    PubMed  Google Scholar 

  17. Franxman TJ, Howe L, Teich E, Greenhawt MJ. Oral food challenge and food allergy quality of life in caregivers of children with food allergy. J Allergy Clin Immunol Pract. 2015;3:50–6.

    PubMed  Google Scholar 

  18. Soller L, Hourihane J, DunnGalvin A. The impact of oral food challenge test on food allergy health-related quality of life. Allergy. 2014;69:1255–7.

    CAS  PubMed  Google Scholar 

  19. Knibb RC, Ibrahim NF, Steifel G, et al. The psychological impact of diagnostic food challenges to confirm the resolution of peanut or tree nut allergy. Clin Exp Allergy. 2012;42:451–9.

    CAS  PubMed  Google Scholar 

  20. Venter C, Meyer R. The challenges of managing food hypersensitivity. Proc Nutr Soc. 2010;69:11–24.

    CAS  PubMed  Google Scholar 

  21. Sicherer SH, Noone SA, Munoz-Furlong A. The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol. 2001;87:461–4.

    CAS  PubMed  Google Scholar 

  22. Avery NJ, Kin RM, Knight S, et al. Assessment of quality of life in children with peanut allergy. Pediatr Allergy Immunol. 2003;14:378–82.

    PubMed  Google Scholar 

  23. Bock SA, Atkins FM. The natural history of peanut allergy. J Allergy Clin Immunol. 1989;83:900–4.

    CAS  PubMed  Google Scholar 

  24. Primeau MN, Kagan R, Joseph L, et al. The psychological burden of peanut allergy as perceived by adults with peanut allergy and the parents of peanut allergic children. Clin Exp Allergy. 2003;30:1135–43.

    Google Scholar 

  25. Sheth SS, Wasserman S, Kagan R, et al. Role of food labels in accidental exposures in food-allergic individuals in Canada. Ann Allergy Asthma Immunol. 2010;104:60–5.

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  27. Furlong TJ, DeSimone J, Sicherer SH. Peanut and tree nut allergic reactions in restaurants and other food establishments. J Allergy Clin Immunol. 2001;108:867–70.

    CAS  PubMed  Google Scholar 

  28. Food Allergy Research and Education Website. https://www.foodallergy.org/life-food-allergies/managing-lifes-milestones/dining-out/food-allergy-chef-cards

  29. Eigenmann PA, Lack G, Mazon A, et al. Managing nut allergy: a remaining clinical challenge. J Allergy Clin Immunol Pract. 2017;5(2):296–300.

    PubMed  Google Scholar 

  30. Greenhawt M, MacGillivray F, Batty G, et al. International study of risk-mitigating factors and in-flight allergic reactions to Peanut and tree nut. J Allergy Clin Immunol Pract. 2013;1(2):186–94.

    PubMed  Google Scholar 

  31. Sicherer SH, Furlong TJ, DeSimone J, Sampson HA. Self-reported allergic reactions to peanut on commercial airliners. J. Allergy Clin Immunol. 1999;104(1):186–9.

    CAS  Google Scholar 

  32. Food Allergen Labeling and Consumer Protection Act (FALCPA). Available at: http://www.fda.gove/downloads/Food/GuidanceREgulation/UCM179394.pdf (2004).

  33. Marchisotto MJ, Harada L, Kamdar O, et al. Food allergen labeling and purchasing habits in the United States and Canada. J Allergy Clin Immunol Pract. 2017;5(2):345–351 e342.

    PubMed  Google Scholar 

  34. European Commission. Commission Directive 2007/68/EC of 27 November 2007 amending Annex IIIa to Directive 2000/13/EC of the European Parliament and of the council as regards certain food ingredients. Off J Eur Union. 2007;310:11–4.

    Google Scholar 

  35. Hefle SL, Furlong TJ, Niemann L, et al. Consumer attitudes and risks associated with packaged foods having advisory labeling regarding the presence of peanuts. J Allergy Clin Immunol. 2007;120:171–6.

    PubMed  Google Scholar 

  36. Food Allergy Research and Education (FARE). Tips for avoiding your allergen. https://www.foodallergy.org/sites/default/files/migrated-files/file/tips-avoid-allergen.pdf

  37. Vlieg-Boerstra BJ, van der Heide S, Bijleveld CM, et al. Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention. Eur J Clin Nutr. 2006;60:1384–90.

    CAS  PubMed  Google Scholar 

  38. Simons FE, Ardusso LR, Dimov V, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013;162:193–204.

    CAS  PubMed  Google Scholar 

  39. Academy of Allergy, Asthma and Immunology (AAAAI). https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/Anaphylaxis-Emergency-Action-Plan.pdf

  40. Food Allergy Research and Education (FARE). https://www.foodallergy.org/sites/default/files/2018-06/emergency-care-plan.pdf

  41. Vila L, Beyer K, Jarvinen KM, et al. Role of conformational and linear epitopes in the achievement of tolerance in cow’s milk allergy. Clin Exp Allergy. 2001;31:1599–606.

    CAS  PubMed  Google Scholar 

  42. Nowak-Wegrzyn A, Fiocchi A. Rare, medium or well done? The effect of heating and food matrix on food protein allergenicity. Curr Opin Allergy Clin Immunol. 2009;9:234–7.

    CAS  PubMed  Google Scholar 

  43. Leanord SA, Nowak-Wegrzyn A. Baked Milk and Egg Diets for Milk and Egg Allergy Management. Immunol Allergy Clin North Am. 2016;36:147–59.

    Google Scholar 

  44. Huang F, Nowak-Wegrzyn A. Extensively heated milk and egg as oral immunotherapy. Curr Opin Allergy Clin Immunol. 2012;12:283–92.

    CAS  PubMed  Google Scholar 

  45. Leonard SA, Caubet JC, Kim JS, et al. Baked milk- and egg-containing diet in the management of milk and egg allergy. J Allergy Clin Immunol Pract. 2015;3:13–23.

    PubMed  Google Scholar 

  46. American Academy of Pediatrics. Committee on nutrition. Hypoallerg Infant Formula Pediatrics. 2000;106:346–9.

    Google Scholar 

  47. Arshad SH. Food allergen avoidance in primary prevention of food allergy. Allergy. 2001;56:113–6.

    PubMed  Google Scholar 

  48. Fiocchi A, Assa’ad A, Bahna S. Food allergy and the introduction of solid foods to infants: a consensus document. Ann Allergy Asthma Immunol. 2006;97:10–21.

    PubMed  Google Scholar 

  49. Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372:803–13.

    PubMed  PubMed Central  Google Scholar 

  50. Palmer DJ, Sullivan TR, Gold MS, Prescott SL, Makrides M. Randomized controlled trial of early regular egg intake to prevent egg allergy. J Allergy Clin Immunol. 2017;139:1600–7.

    CAS  PubMed  Google Scholar 

  51. Natsume O, Kabashima S, Nakazato J, et al. Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double-blind, placebo-controlled trial. Lancet. 2017;389:276–86.

    PubMed  Google Scholar 

  52. Perkin MR, Logan K, Tseng A, et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016;374:1733–43.

    CAS  PubMed  Google Scholar 

  53. Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. J Allergy Clin Immunol. 2017;139:29–44.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Melanie M. Makhija

  2. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Melanie M. Makhija

Authors
  1. Melanie M. Makhija
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melanie M. Makhija .

Editor information

Editors and Affiliations

  1. Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Ruchi S. Gupta

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Makhija, M.M. (2020). Clinical Management of Food Allergy. In: Gupta, R. (eds) Pediatric Food Allergy . Springer, Cham. https://doi.org/10.1007/978-3-030-33292-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-33292-1_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33291-4

  • Online ISBN: 978-3-030-33292-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation