[Food allergy]

Abstract

Food allergy (hypersensitivity) is a form of adverse food reaction in which the reaction is caused by an immunological response to a food. The majority of immediate allergic reactions to food are IgE-mediated. Although the true prevalence of food allergy is unknown, it is said to be higher in children than in adults. Data suggest that the prevalence in the general population is about 1%. In children the most common foods eliciting an allergic reaction are cow's milk, eggs, fish, peanuts and soy. In adults celery, fish, nuts, peanuts and shrimp are the major source of food allergy. Usually, food-allergic adults are sensitized to pollen, e.g. in the frame of the celery-carrot-mugwort-spice syndrome. There is some evidence that antigenic similarity exists between pollen and food proteins. Clinical signs and symptoms due to food allergy are cutaneous, respiratory, gastrointestinal reactions such as urticaria, laryngeal edema, asthma or diarrhea. Food anaphylaxis is the most severe generalized and sometimes fatal reaction. History, physical examination, skin tests and laboratory tests (RAST) provide the basic tools for identifying a food allergy. However, the "gold standard" for diagnosing allergic food reactions is the double-blind, placebo-controlled food challenge. The predictive accuracy of positive skin tests is less than 50%, as demonstrated by double-blind, placebo-controlled food challenges. The only proven form of management in food allergy is strict elimination of the offending food. Food-allergic individuals must be provided with an emergency kit containing an oral antihistamine of the second generation and a corticosteroid.(ABSTRACT TRUNCATED AT 250 WORDS)