Abstract
Summary: Food allergic patients have to deal with an avoidance diet. Confusing labelling terms or precautionary labels can result in misinterpretation and risk-taking behaviour. Even those patients that strictly adhere to their diet experience (sometimes severe) unexpected allergic reactions to food. The frequency, severity and causes of such reactions are unknown. The objective of this review was to describe the frequency, severity and causes of unexpected allergic reactions to food in food allergic patients aged > 12 years, in order to develop improved strategies to deal with their allergy. A systematic review was carried out by two researchers, in six electronic databases (CINAHL, Cochrane, EMBASE, Medline, Psychinfo and Scopus). The search was performed with keywords relating to the frequency, severity and causes of unexpected allergic reactions to food. This resulted in 24 studies which met the inclusion criteria; 18 observational and six qualitative studies. This review shows that knowledge about the frequency of unexpected reactions is limited. Peanut, nuts, egg, fruit/vegetables and milk are the main causal foods. Severe reactions and even fatalities occur. Most reactions take place at home, but a significant number also take place when eating at friends' houses or in restaurants. Labelling issues, but also attitude and risky behaviour of patients can attribute to unexpected reactions. We conclude that prospective studies are needed to get more insight in the frequency, severity, quantity of unintended allergen ingested and causes of unexpected allergic reactions to food, to be able to optimize strategies to support patients in dealing with their food allergy. Although the exact frequency is not known, unexpected reactions to food occur in a significant number of patients and can be severe. For clinical practice, this means that patient education and dietary instructions are necessary. © 2014 John Wiley & Sons Ltd.
Highlights
Food allergic patients have to deal with their diet
Confusing labelling terms of precautionary labels can result in risk-taking behaviour. Even those patients that strictly adhere to their diet experience mild and severe unexpected allergic reactions to food during their life
The aim was of this study was to describe the frequency, severity and causes of unexpected allergic reactions to food in food allergic patients, aged >12 years, in order to improve health care for these patients
Summary
Severity and causes of unexpected allergic reactions to food, a systematic literature review. A Versluis1*, A Knulst, A Kruizinga, A Michelsen, G Houben, J Baumert, H Van Os-Medendorp. From Food Allergy and Anaphylaxis Meeting (FAAM 2013) Nice, France. From Food Allergy and Anaphylaxis Meeting (FAAM 2013) Nice, France. 7-9 February 2013
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