Food allergy: 1992 and beyond

Abstract

Food allergy is a common clinical problem and its incidence may be increasing. It is both underdiagnosed and overdiagnosed. IgE-mediated mechanisms have been studied extensively but other immunologic processes may also be important in individual patients. The diagnosis is based on history, skin tests, in vitro tests, and finally, placebo-controlled double-blind food challenge. Management consists of strict avoidance of the foods proven to cause problems. Recent studies attempting prevention of allergic disease in high risk families have shown the beneficial effects of exclusive breast feeding, particularly if the mother avoids certain common food allergens from her own diet. If a supplement is required, a hydrolyzed formula is far superior to a conventional cow's milk formula or a soy-based formula. Delayed introduction of solid foods, particularly egg, fish and peanut is desirable. These preventive strategies are cost-effective.