RETROSPECTIVE REVIEW OF ORAL FOOD CHALLENGE OUTCOMES IN A MILITARY MEDICAL CENTER

Abstract

<h3>Introduction</h3> Oral food challenges (OFCs) are the gold standard for diagnosis of food allergies. Limited data exists comparing OFCs across adult and pediatric subgroups in the military's health care system. The purpose of this study is to identify clinical and laboratory predictors of negative OFCs in one military medical center. <h3>Methods</h3> A retrospective chart review was performed on all open OFCs between June 2014 and June 2021 at a military tertiary center allergy clinic. <h3>Results</h3> 652 patients who underwent 1,112 OFCs were included with 910 negative total OFCs (81.8%). A total of 615 pediatric (82.0%) and 294 of adult (81.4%) passed their OFCs. Successful OFCs were highest among almond (94.4%), shrimp (94.2%), crab (91.9%), and egg (88.9%) and lowest among cashew (62.0%), walnut (63.5%), pistachio (69.7%), and pecan (71.2%). There was statistical significance in outcomes when analyzing sIgE (P <0.001), SPT wheal size (P <0.001), and history of a prior failed challenge (p=0.042). Walnut OFCs demonstrated an outcome difference between age groups (P= 0.008) – pediatrics subgroup with a higher pass rate (74.4%) compared to adults (40.0%). Higher levels of Ara h2 were also associated with a greater number of failed challenges (p= 0.045). <h3>Conclusion</h3> For OFCs performed in a military medical center which can influence career decisions, sIgE is a reliable lab marker in risk stratification of outcomes. Higher Ara h 2 was associated with failed OFCs. A significant difference in pass rate was noted between pediatric and adult populations for certain foods.