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SELECTED ARTICLES FROM THE RECENT LITERATURE 2008
5/6/2008
Usefulness and Safety in Office Food Challenge
Summary
These investigators reported a series of 109 patients who underwent a total of 150 open food challenges. Twenty-seven percent of these challenges (40) were positive. These reactions occurred in 33 patients. Reactions were mild to moderate in 92% of positive challenges. Cutaneous reactions occurred in only 68% of positive challenges. The next most common organ involved was the gastrointestinal tract which demonstrated symptoms in 45%. The respiratory tract was involved in 38%, excluding laryngeal symptoms. No patient had cardiovascular involvement.
Of note is that food specific IgE values failed to correlate with reaction severity. No patient required epinephrine and none required hospitalization.
Previously published negative predictive values for specific IgE were validated by negative challenges to milk, peanut, and egg. These negative challenges allowed for the introduction of 19 different foods to the diet of 88 patients.
The authors concluded that open food challenges are safe in the office setting for patients selected on the basis of history and food specific IgE approaching negative predictive values.
Reference
Mankad VS, et al. Safety of open food challenges in the office setting. Annals of Allergy, Asthma, and Immunology 2008; 100(5)469-474.
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