ABSTRACT
Clinical Questions .................................................................................................. 129 Introduction ............................................................................................................ 130 The Importance of the Medical History as a Diagnostic Test ................................ 130
Food Diaries ...................................................................................................... 134 Allergy Tests .......................................................................................................... 135
Skin Testing ....................................................................................................... 135 Skin Prick Testing (SPT) .............................................................................. 135 Intradermal Skin Tests .................................................................................. 137 Atopy Patch Test ........................................................................................... 138
Serum Allergy Testing ....................................................................................... 138 Allergen-Specific Serum IgE (SpIgE) .......................................................... 138
Complementary Use of SPT and SpIgE ............................................................ 139 Testing for Serum IgE to Individual Components (Component Resolved Diagnostics) .................................................................................................. 140 Total Serum Immunoglobulin E ................................................................... 141
Elimination Diets ................................................................................................... 141 Oral Food Challenge (OFC) ................................................................................... 142 Unproven Tests That Are Not Recommended ........................................................ 144 Conclusions ............................................................................................................ 145 Clinical Pearls ........................................................................................................ 145 References .............................................................................................................. 146
It is important to diagnose food allergy correctly to avoid social and nutritional deficits and to ensure the safety of the patient. Mislabeling an individual with food allergy, when they are not truly allergic, can lead to nutritional deficiencies, as allergen avoidance usually includes major staple foods such as milk and egg.1-3 Conversely, there are inherent dangers from missing a diagnosis of food allergy because a patient who is not accurately diagnosed will be open to further allergen exposure resulting in allergic reaction potentially including life-threatening anaphylaxis. Therefore it is incumbent on the physician to ensure a proper diagnosis.
