Investigations

Key Messages:

  • Clinical history is an essential part of the diagnosis pathway for all cases of suspected food allergy
  • Good first-line tests for IgE-mediated food allergy include skin prick tests and specific IgE blood tests
  • Testing should be focused on the foods reported to cause symptoms
  • Individuals who are pollen sensitised can have positive tests to pollen-related foods such as nuts, which may not be indicative of an allergy to peanuts or tree nuts
  • Testing for individual allergens using component-resolved diagnostics is useful in pollen sensitised individuals, those with suspected co-factor induced allergy, and to assess the likelihood of resolution to milk or egg
  • There are no validated tests for non-IgE-mediated allergy or non-immune-mediated food hypersensitivity, so a supervised 6-8 week exclusion of the suspected food(s) may be necessary
  • Oral food challenges are the gold standard diagnostic test for food allergy

NICE guidance on the diagnosis of food allergy in children and young people gives a good overview of the diagnosis pathway for suspected food allergy. 

More recently, a quality standard has also been produced (NICE 2016).

Unfortunately, there is no such standard or guideline specifically for adult-onset food allergy.

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Skin Prick Tests and specific IgE tests

Announcement

BSACI Global Allergy Online Symposium 2023

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