New Rules for Food Allergies
An interesting article in the Wall Street Journal about food allergies:
Fewer Children May Be Diagnosed as Doctors Told Not to Rely Solely on Standard Skin and Blood Tests
Parents who have eliminated foods from their children’s diets based on allergy tests alone may find that some are safe to eat after all.
The National Institute for Allergy and Infectious Diseases issued the first clinical guidelines for diagnosing and treating food allergies Monday, saying that blood or skin tests aren’t sufficient when making a diagnosis.
An allergy should be suspected if someone has a reaction within minutes or hours of eating a food, according to the guidelines. Physicians should then take a detailed medical history, conduct a physical exam and confirm the allergy with a skin-prick test, in which tiny drops of the suspected allergen are pricked into the skin, usually in the forearm, to see if red wheals form. None of those steps is definitive by itself, the recommendations say, which will likely to lead to fewer diagnoses.
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Medical history is the most important key to a diagnosis, experts say. “The major piece of the puzzle is what happened? What did they eat and when? How long was it between eating and having symptoms? What else was going on?” says A. Wesley Burks, chief of pediatric allergy and immunology at Duke University Medical Center and another author of the guidelines. In the real world, it’s often far from clear which of dozens of different foods a child eats during the day, or what unknown ingredient in a restaurant meal, may have set off a reaction. That’s why the guidelines also call for using a skin-prick test to verify that the patient does have an immune reaction to a suspected food.
In more than 50% of cases, the report notes, the presumed food allergy isn’t a real allergy. A different food could be responsible, or there could be some other cause entirely, particularly with gastrointestinal symptoms.