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The diagnosis of food allergy in children

Berni Canani, Roberto; Ruotolo, Serena; Discepolo, Valentina; Troncone, Riccardo

doi: 10.1097/MOP.0b013e32830c6f02
Gastroenterology and nutrition: Edited by Robert Wyllie

Purpose of review To give an update about the optimal diagnostic work-up for children with suspected food allergy.

Recent findings Food allergy has become a very severe health problem not only for many children and parents, but also for the entire medical and paramedical community. The financial and social costs related to these conditions are increasing, but, contemporarily, basic and clinical research are deeply involved in the search of possible solutions to facilitate the management of these patients.

Summary Food allergy is defined as an abnormal immunological reaction to food proteins, which causes an adverse clinical reaction. Over 90% of food allergies in childhood are caused by eight foods: cow's milk, hen's egg, soy, peanuts, tree nuts, wheat, fish and shellfish. The evaluation of a child with suspected food allergy includes detailed medical history, physical examination, screening tests and response to elimination diet and to oral food challenge. None of the screening tests, alone or in combination, can definitely diagnose or exclude it. The main principle of food allergy management is avoidance of the offending antigen. An incorrect diagnosis is likely to result in unnecessary dietary restrictions, which, if prolonged, may adversely affect the child's nutritional status and growth.

Department of Paediatrics and European Laboratory for the Investigation of Food-Induced Diseases, University ‘Federico II’, Naples, Italy

Correspondence to Riccardo Troncone, MD, Department of Pediatrics, University of Naples ‘Federico II’, Via S. Pansini, 5 80131 Naples, Italy Tel: +39 081 7463383; fax: +39 081 5469811; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.