EAACI guidelines on the diagnosis of IgE-mediated food allergy
Por:
Santos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, Alvaro-Lozano M, Ballmer-Weber B, Barni S, Beyer K, Bindslev-Jensen C, Brough HA, Buyuktiryaki B, Chu D, Del Giacco S, Dunn-Galvin A, Eberlein B, Ebisawa M, Eigenmann P, Eiwegger T, Feeney M, Fernandez-Rivas M, Fisher HR, Fleischer DM, Giovannini M, Gray C, Hoffmann-Sommergruber K, Halken S, Hourihane JO, Jones CJ, Jutel M, Knol E, Konstantinou GN, Lack G, Lau S, Marques Mejias A, Marchisotto MJ, Meyer R, Mortz CG, Moya B, Muraro A, Nilsson C, Lopes de Oliveira LC, O'Mahony L, Papadopoulos NG, Perrett K, Peters RL, Podesta M, Poulsen LK, Roberts G, Sampson HA, Schwarze J, Smith P, Tham EH, Untersmayr E, Van Ree R, Venter C, Vickery BP, Vlieg-Boerstra B, Werfel T, Worm M, Du Toit G and Skypala I
Publicada:
1 dic 2023
Ahead of Print:
1 oct 2023
Resumen:
This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
Filiaciones:
Santos AF:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Riggioni C:
Department of Allergy and Clinical Immunology, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Agache I:
Faculty of Medicine, Transylvania University, Brasov, Romania
Akdis CA:
Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
Akdis M:
Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
Alvarez-Perea A:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Gregorio Marañón Health Research Institute, Madrid, Spain
Alvaro-Lozano M:
Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain
Institut de Recerca Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
Ballmer-Weber B:
Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
Barni S:
Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Beyer K:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
Bindslev-Jensen C:
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
Brough HA:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Buyuktiryaki B:
Division of Pediatric Allergy, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
Chu D:
McMaster University, Ontario, Hamilton, Canada
Del Giacco S:
Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology, University Hospital "Duilio Casula", University of Cagliari, Cagliari, Italy
Dunn-Galvin A:
Paediatrics and Child Health, INFANT Centre, HRB-CRF, University College Cork, Cork, Ireland
Paediatrics and Child Health, Royal College of Surgeons in Ireland, Children's Health Ireland, Dublin, Ireland
Eberlein B:
Department of Dermatology and Allergy Biederstein, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
Ebisawa M:
Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan
Eigenmann P:
Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland
Eiwegger T:
Translational Medicine Program, Research Institute, Hospital for Sick Children, Ontario, Toronto, Canada
Department of Immunology, Temerty Faculty of Medicine, University of Toronto, Ontario, Toronto, Canada
Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
Department of Pediatric and Adolescent Medicine, University Hospital St. Pölten, St.Pölten, Austria
Feeney M:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Fernandez-Rivas M:
Allergy Department, Hospital Clinico San Carlos, Madrid, Spain
Facultad de Medicina, IdISSC, ARADyAL, Universidad Complutense, Madrid, Spain
Fisher HR:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Fleischer DM:
Children's Hospital Colorado, University of Colorado School of Medicine, Colorado, Aurora, USA
Giovannini M:
Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy
Department of Health Sciences, University of Florence, Florence, Italy
Gray C:
Red Cross Children's Hospital and Kidsallergy Centre, Cape Town, South Africa
Department of Paediatrics, University of Cape Town, Cape Town, South Africa
Hoffmann-Sommergruber K:
Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Halken S:
Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
Hourihane JO:
Royal College of Surgeons in Ireland and Childrens Health Ireland, Dublin, Ireland
Jones CJ:
Faculty of Medical Sciences, School of Psychology, University of Surrey, Surrey, UK
Jutel M:
Department of Clinical Immunology, ALL-MED Medical Research Institute, Wroclaw Medical University, Wroclaw, Poland
Knol E:
Department of Dermatology/Allergology, Center of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Konstantinou GN:
Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
Lack G:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Lau S:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
Marques Mejias A:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Marchisotto MJ:
MJM Advisory, New York, New York, USA
Meyer R:
Department of Medicine, Imperial College, London, UK
Department of Nutrition and Dietetics, Winchester University, Winchester, UK
Department of Medicine, KU Leuven, Leuven, Belgium
Mortz CG:
Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
Moya B:
Department of Allergy, Hospital Universitario 12 de Octubre, Madrid, Spain
Instituto de Investigación Sanitaria, Hospital 12 de Octubre (imas12), Madrid, Spain
Muraro A:
Food Allergy Referral Centre, Padua University Hospital, Padua, Italy
Nilsson C:
Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
Sachs Children and Youth Hospital, South Hospital, Stockholm, Sweden
Lopes de Oliveira LC:
Division of Allergy and Clinical Immunology, Department of Paediatrics, Federal University of São Paulo, São Paulo, Brazil
O'Mahony L:
Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
Papadopoulos NG:
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Lydia Becker Institute, University of Manchester, Manchester, UK
Perrett K:
Department of Paediatrics, University of Melbourne, Victoria, Parkville, Australia
Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Parkville, Australia
Population Allergy Research Group, Murdoch Children's Research Institute, Victoria, Parkville, Australia
Peters RL:
Department of Paediatrics, University of Melbourne, Victoria, Parkville, Australia
Department of Allergy and Immunology, Royal Children's Hospital, Victoria, Parkville, Australia
Population Allergy Research Group, Murdoch Children's Research Institute, Victoria, Parkville, Australia
Podesta M:
EFA - European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
Poulsen LK:
Allergy Clinic, Copenhagen University Hospital at Herlev-Gentofte, Copenhagen, Denmark
Roberts G:
Department of Paediatric Allergy and Respiratory Medicine, University of Southampton, Southampton, UK
NIHR Southampton Biomedical Research Centre, Southampton, UK
David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK
Sampson HA:
Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Schwarze J:
Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
Smith P:
Clinical Medicine, Griffith University, Queensland, Southport, Australia
Queensland Allergy Services Private Practice, Queensland, Southport, Australia
Tham EH:
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore
Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Untersmayr E:
Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Van Ree R:
Departments of Experimental Immunology and of Otorhinolaryngoloy, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Venter C:
Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado, Colorado, Aurora, USA
Vickery BP:
Emory University School of Medicine and Children's Healthcare of Atlanta, Georgia, Atlanta, USA
Vlieg-Boerstra B:
Department of Paediatrics, OLVG Hospital, Amsterdam, the Netherlands
Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands
Vlieg Dieticians, Private Practice for Dietary Management of Food Allergy, Arnhem, The Netherlands
Werfel T:
Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
Worm M:
Division of Allergy and immunology, Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
Du Toit G:
Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
Skypala I:
Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
Department of Inflammation and Repair, Imperial College, London, UK
Univ Cagliari, Univ Hosp Duilio Casula, Unit Allergy & Clin Immunol, Cagliari, Italy
Univ Cagliari, Univ Hosp Duilio Casula, Unit Allergy & Clin Immunol, Cagliari, Italy
Univ Cagliari, Univ Hosp Duilio Casula, Unit Allergy & Clin Immunol, Cagliari, Italy
Univ Cagliari, Univ Hosp Duilio Casula, Unit Allergy & Clin Immunol, Cagliari, Italy
Green Submitted, Green Accepted, hybrid
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