FOODS

Abstract

Controlled studies of food hypersensitivity have provided a better understanding of systemic reactions following food ingestion. Common features in reported cases include previous episodes of anaphylaxis with the incriminated foods, a failure to recognize early symptoms of anaphylaxis, and a delay or lack of immediate use of subcutaneous epinephrine to treat these systemic, allergic reactions. Potential mechanisms underlying the pathogenesis of food hypersensitivity reactions and new insights into other clinical conditions thought to be triggered by food allergy have been discussed. The DBPCFC remains the “diagnostic gold standard” for food hypersensitivity, but properly designed open- and single-blinded food challenges can also be useful in certain situations in the initial clinical assessment of food allergy. Strict elimination of the responsible food allergen remains the only proven therapy to prevent fatal and nearly fatal reactions in persons at risk. Patient education measures regarding food allergy are very important and should include the recognition of important clinical symptoms and specific instructions on the immediate administration of epinephrine in suspected cases of anaphylaxis. Future controlled studies of foodinduced anaphylaxis will help provide a better overall understanding of this medical condition. Finally, more comprehensive epidemiologic studies are needed to determine the actual incidence and prevalence of foodinduced anaphylaxis.