Article

Food allergy in infants and children: clinical evaluation and management.

Allergy Unit, Kipper Institute of Immunology, Children's Medical Center of Israel, Petah Tikva.
Israel journal of medical sciences 01/1995; 30(12):873-9. pp.873-9
Source: PubMed

ABSTRACT A total of 122 infants and children up to age 17 (69 males and 53 females) who were referred for food allergy to the Pediatric Allergy and Clinical Immunology Unit were evaluated by complete history, emphasizing the implicated foods, clinical presentation and involvement of various organ systems, physical examination, and prick skin tests to food allergens. Fourteen infants with a history of egg white allergy and positive skin tests to egg white also underwent skin tests (prick and intradermal in 1:100 dilution) to measles-mumps-rubella (MMR) vaccine; 35 children under 3 years old had 41 oral challenges with the suspected foods; and 9 children over 3 years old had 12 oral challenges with the suspected foods. We found that cow milk/humanized milk formula, egg white, soybean, and peanut are the main allergenic foods in the pediatric population. Thirteen children had 13 positive oral challenges: 12 to cow milk/humanized milk formula and one to egg white. Symptoms reproduced by oral challenges included urticarial and erythematous rash, conjunctival itching, angioedema, abdominal pain, vomiting, diarrhea, and rhinorrhea. No anaphylactic shock was reported. Negative skin test has an excellent predictive accuracy for negative oral challenge with the suspected food in children > 3 years old. The negative predictive accuracy of cow milk skin test in children < 3 years was 73%. Positive skin test is not a good predictor of a clinical reaction to food. Oral food challenge performed cautiously in a medical setting is the "gold standard" for diagnosis. MMR vaccine can be safely administered to infants with egg white allergy after skin tests with the vaccine are performed.

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    B Krane Kvenshagen, M Jacobsen, R Halvorsen
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    Allergologia et Immunopathologia 38(6):321-6. · 1.04 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

3 years old
 
35 children
 
9 children
 
abdominal pain
 
cow milk skin test
 
egg white
 
egg white allergy
 
excellent predictive accuracy
 
food allergy
 
main allergenic foods
 
MMR vaccine
 
negative oral challenge
 
negative predictive accuracy
 
Negative skin test
 
Oral food challenge
 
Pediatric Allergy
 
prick skin tests
 
suspected food
 
Symptoms reproduced
 
various organ systems