EAACI guidelines on the diagnosis of IgE‐mediated food allergy

• DOI: 10.1111/all.15902
• Publication Date: 2023-10-12T03:44:48Z
• Authors: Alexandra F. Santos; Carmen Riggioni; Ioana Agache; Cezmi A. Akdis; Mubeccel Akdis; Alberto Alvarez‐P...; Montserrat Alvaro...; Barbara Ballmer‐W...; Simona Barni; Kirsten Beyer; Carsten Bindslev‐...; Helen A. Brough; Betul Buyuktiryaki; Derek Chu; Stefano Del Giacco; Audrey Dunn‐Galvin; Bernadette Eberlein; Motohiro Ebisawa; Philippe Eigenmann; Thomas Eiwegger; Mary Feeney; Montserrat Fernan...; Helen R. Fisher; David M. Fleischer; Mattia Giovannini; Claudia Gray; Karin Hoffmann‐So...; Susanne Halken; Jonathan O’B. Hou...; Christina J. Jones; Marek Jutel; Edward Knol; George N. Konstan...; Gideon Lack; Susanne Lau; Andreina Marques ...; Mary Jane Marchis...; Rosan Meyer; Charlotte G. Mortz; Beatriz Moya; Antonella Muraro; Caroline Nilsson; Lucila Camargo Lo...; Liam O’Mahony; Nikolaos G. Papad...; Kirsten Perrett; Rachel L. Peters; Marcia Podesta; Lars K. Poulsen; Graham Roberts; Hugh A. Sampson; Jürgen Schwarze; Peter Smith; Elizabeth Huiwen ...; Eva Untersmayr; Ronald Van Ree; Carina Venter; Brian P. Vickery; Berber Vlieg‐Boer...; Thomas Werfel; Margitta Worm; George Du Toit; Isabel Skypala
• Keywords: Oral allergy syndrome; Oral food challenge; Basophil activation; Peanut Allergy; Egg allergy; Guideline

Abstract This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE‐mediated food allergy was developed using the Grading Recommendations, Assessment, Development Evaluations (GRADE) approach. Food diagnosis starts with an allergy‐focused clinical history followed by tests to determine IgE sensitization, such as serum allergen‐specific (sIgE) skin prick test (SPT), basophil activation (BAT), if available. Evidence sensitization should be sought any suspected foods. The some foods, peanut cashew nut, is well supported SPT sIgE, whereas there are less data performance these poorer other wheat soya. measurement sIgE allergen components Ara h 2 from peanut, Cor a 14 hazelnut Ana o 3 can useful further support diagnosis, especially in pollen‐sensitized individuals. BAT sesame used additionally. reference standard oral challenge (OFC). OFC performed equivocal cases. For practical reasons, open challenges suitable most Reassessment allergic children and/or OFCs periodically over time will enable reintroduction into diet case spontaneous acquisition tolerance.