Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital

Main Article Content

Guilia Ballini
Chiara Gavagni
Caterina Guidotti
Giulia Ciolini
Giulia Liccioli
Mattia Giovannini
Lucrezia Sarti
Daniele Ciofi
Elio Novembre
Francesca Mori
Simona Barni

Keywords

children; food allergy; food protein-induced enterocolitis syndrome; IgE mediated; oral food challenge; trigger food

Abstract

Introduction and objective: The oral food challenge (OFC) is the gold standard to diagnose food allergy (FA); however, it is not a procedure free from the risk of having significant allergic reactions, even life-threatening.
The aims of our study were to evaluate the frequency of positive OFCs performed in chil-dren with a suspected diagnosis of IgE- and non-IgE–mediated (food protein–induced enterocolitis syndrome (FPIES)) FA and how the failed challenges were managed.
Materials and methods: A retrospective chart review was done on all children who have had OFCs in a tertiary-care pediatric allergy unit from 2017 to 2019.
Results: 682 patients were enrolled and 2206 challenges were performed: 2058 (93%) for IgE-mediated FA and 148 (7%) for FPIES. There were 262 (11.8%) challenge failures. The transfer to the emergency department was required 3 times (1.1%). None of the failed challenges resulted in death or hospitalization and 13.3% challenges did not require any treatment.
Conclusions: Our findings confirm that food challenges can be performed safely in a specialized setting by well-trained personnel; all food challenge reactions, even the most serious, were reversible, thanks to a prompt recognition and treatment that generally did not worsen over time.

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