Characteristics of Patients Undergoing Oral Food Challenges in an Urban Medical Center

Abstract

RationaleOral food challenges are necessary for the diagnosis and reassessment of food allergy. Success rates of food challenges in this academic medical center utilizing current recommended serologic criteria for eligibility have not been previously evaluated.MethodsA retrospective chart review was performed of children who had undergone oral food challenge at the University of Maryland Asthma and Allergy Practice from 2004 to 2007. Demographic and clinical data, skin test and ImmunoCAP results were collected and compared to food challenge outcomes.ResultsOne-hundred and twenty-nine oral food challenges performed on 92 patients (15 months-22 years) were reviewed. Overall, 26% of the challenges resulted in reactions, with egg (34%) and milk (41%) having the highest failure rates. Caucasians (28%, 24/85) had a slightly higher rate of failure compared to African-Americans (20%, 7/35) and males (26%, 27/90) had a higher failure rate than females (15%, 6/39). Patients in the failure group had higher rates of asthma, allergic rhinitis and other food allergies than the pass group. There was no difference in age or symptoms with initial exposure. Forty-six percent of patients who failed had a skin test wheal of <3 mm and 75% had an ImmunoCAP <2 kU/L.ConclusionsPatients who failed oral food challenges were more likely to have co-morbid conditions and other food allergies. Seventy-five percent of patients who failed had an ImmunoCAP <2 kU/L which has been considered by many to be a safe level for a challenge. RationaleOral food challenges are necessary for the diagnosis and reassessment of food allergy. Success rates of food challenges in this academic medical center utilizing current recommended serologic criteria for eligibility have not been previously evaluated. Oral food challenges are necessary for the diagnosis and reassessment of food allergy. Success rates of food challenges in this academic medical center utilizing current recommended serologic criteria for eligibility have not been previously evaluated. MethodsA retrospective chart review was performed of children who had undergone oral food challenge at the University of Maryland Asthma and Allergy Practice from 2004 to 2007. Demographic and clinical data, skin test and ImmunoCAP results were collected and compared to food challenge outcomes. A retrospective chart review was performed of children who had undergone oral food challenge at the University of Maryland Asthma and Allergy Practice from 2004 to 2007. Demographic and clinical data, skin test and ImmunoCAP results were collected and compared to food challenge outcomes. ResultsOne-hundred and twenty-nine oral food challenges performed on 92 patients (15 months-22 years) were reviewed. Overall, 26% of the challenges resulted in reactions, with egg (34%) and milk (41%) having the highest failure rates. Caucasians (28%, 24/85) had a slightly higher rate of failure compared to African-Americans (20%, 7/35) and males (26%, 27/90) had a higher failure rate than females (15%, 6/39). Patients in the failure group had higher rates of asthma, allergic rhinitis and other food allergies than the pass group. There was no difference in age or symptoms with initial exposure. Forty-six percent of patients who failed had a skin test wheal of <3 mm and 75% had an ImmunoCAP <2 kU/L. One-hundred and twenty-nine oral food challenges performed on 92 patients (15 months-22 years) were reviewed. Overall, 26% of the challenges resulted in reactions, with egg (34%) and milk (41%) having the highest failure rates. Caucasians (28%, 24/85) had a slightly higher rate of failure compared to African-Americans (20%, 7/35) and males (26%, 27/90) had a higher failure rate than females (15%, 6/39). Patients in the failure group had higher rates of asthma, allergic rhinitis and other food allergies than the pass group. There was no difference in age or symptoms with initial exposure. Forty-six percent of patients who failed had a skin test wheal of <3 mm and 75% had an ImmunoCAP <2 kU/L. ConclusionsPatients who failed oral food challenges were more likely to have co-morbid conditions and other food allergies. Seventy-five percent of patients who failed had an ImmunoCAP <2 kU/L which has been considered by many to be a safe level for a challenge. Patients who failed oral food challenges were more likely to have co-morbid conditions and other food allergies. Seventy-five percent of patients who failed had an ImmunoCAP <2 kU/L which has been considered by many to be a safe level for a challenge.