Abstract
non-IgE and mixed gastrointestinal food allergies present various specific, well-characterized clinical pictures such as food protein-induced allergic proctocolitis, food protein-induced enterocolitis and food protein-induced enteropathy syndrome as well as eosinophilic gastrointestinal disorders such as eosinophilic esophagitis, allergic eosinophilic gastroenteritis and eosinophilic colitis. The aim of this article is to provide an updated review of their different clinical presentations, to suggest a correct approach to their diagnosis and to discuss the usefulness of both old and new diagnostic tools, including fecal biomarkers, atopy patch tests, endoscopy, specific IgG and IgG4 testing, allergen-specific lymphocyte stimulation test (ALST) and clinical score (CoMiss).
Highlights
We evaluated the accuracy of atopy patch test (APT) compared to Oral food challenge (OFC) using a PICO system
This review evaluated studies of the diagnostic value of APT compared to OFC in children with FA
Non-immunoglobulin E (IgE) mediated and mixed FA constitute a heterogeneous group of diseases arising through immunological mechanisms that are not yet well understood
Summary
Food allergy (FA) is defined as an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food [1]. They are characterized by the presence of specific serum IgE (sIgE) or a positive skin prick test (SPT). They occur most frequently in the first years of life, giving rise to urticaria/angioedema, oral allergic syndrome, rhinitis, or acute asthma and anaphylaxis [1]. Non-IgE FA are characterized by cutaneous reactions (such as atopic dermatitis, contact dermatitis and herpetiform dermatitis), respiratory reactions (such as Heiner’s syndrome) or gastrointestinal reactions, which we will discuss in more detail below [2]
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