The approach to the diagnosis of food allergy requires consideration of the history, the epidemiology of food allergic disease, cross-reactivity, and the degree of positivity of tests; these must be evaluated to assist in diagnosis.
Guidelines state that parent and patient reports of food allergies must be confirmed with appropriate laboratory testing and evaluation. Simple tests for food-specific IgE antibodies are available, but the clinician must appreciate that a positive test for food-specific IgE primarily denotes sensitization and may not confirm clinical allergy.
A physician-supervised oral food challenge is recognized as the best and most reliable method for diagnosing peanut allergy. Serum-specific IgE and skin-prick testing can help determine patients that undergo an oral food challenge. Guidelines state that double-blind, placebo-controlled food challenge is the criterion standard.
Basophil histamine-release assays are primarily limited to research settings and have not been shown conclusively to provide reproducible results that are useful for diagnostic testing in a clinical setting.
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Cite this: Michael A. Kaliner. Fast Five Quiz: Food Allergies - Medscape - Sep 08, 2020.