Diagnosing and Treating Food Allergy

Food allergy (FA) is defined as an abnormal immunological reaction to food proteins. Over 90 % of FAs in childhood are caused by eight foods: cow’s milk, hen’s egg, soy, peanuts, tree nuts, wheat, fish and shellfish. The diagnostic work up for a child with suspected FA includes detailed medical history, physical examination, FA screening tests and response to elimination diet and to oral food challenge. Sometimes additional diagnostic tools to explore intestinal damage and function could be adopted. Currently, the only treatment for FA relies on strict elimination diets supervised by the nutritionist. Main new therapeutic strategies for FA include allergen-specific (oral, sublingual, epicutaneous, subcutaneous immunotherapy and heat treatment of food) and non-allergen-specific therapies (humanized monoclonal antibodies, anti-IgE and anti-IL5, probiotics). An incorrect diagnosis is likely to result in unnecessary dietary restrictions, which, if prolonged, may adversely affect the child’s nutritional status and growth.