History and Physical Examination

Symptoms of food-induced anaphylaxis can include the following:

Oropharyngeal pruritus
Angioedema (eg, laryngeal edema)
Stridor
Dysphonia
Cough
Dyspnea
Wheezing
Nausea
Vomiting
Diarrhea
Flushing
Urticaria
Angioedema
Ocular injection, ocular pruritus, conjunctival edema, periocular swelling
Nasal congestion, nasal pruritus, rhinorrhea, and sneezing
Abdominal pain
Feeling of impending doom
Cardiovascular collapse

History

Necessary elements of a thorough medical history include the following:

Develop a complete list of all foods suspected to cause symptoms
Discuss the manner of preparation of the food (cooked, raw, added spices or other ingredients)
Determine the minimum quantity of food exposure required to cause the symptoms
Determine the reproducibility of symptoms upon exposure to the food
Inquire about a personal or family history of other allergic disease
Inquire about eliciting factors that can potentiate a food-allergic reaction (eg, exercise^[1], nonsteroidal anti-inflammatory drugs [NSAIDs], or alcohol)

In addition, obtain a thorough description of each reaction, including the following:

The route of exposure (ingestion, skin contact, inhalation) and dose
The timing of the onset of symptoms in relation to food exposure
All observed symptoms and each one’s severity
The duration of the reaction
The treatment provided and the clinical response to treatment
The most recent reaction

Food-associated exercise-induced anaphylaxis describes a disorder in which exercise is tolerated and a food or foods are tolerated, but when exercise follows ingestion of a specific food or foods, anaphylaxis results.^[50]

Physical examination

The physical examination findings are most useful for assessing overall nutritional status, growth parameters, and signs of other allergic disease, such as atopic dermatitis, allergic rhinitis, or asthma.

Findings from a comprehensive physical examination can help rule out other conditions that may mimic food allergy.

Differential Diagnoses

Niggemann B, Beyer K. Factors augmenting allergic reactions. Allergy. 2014 Dec. 69 (12):1582-7. [QxMD MEDLINE Link].
Sicherer SH. Clinical implications of cross-reactive food allergens. J Allergy Clin Immunol. 2001 Dec. 108(6):881-90. [QxMD MEDLINE Link].
Fleischer DM, Burks AW, Vickery BP, Scurlock AM, Wood RA, Jones SM, et al. Sublingual immunotherapy for peanut allergy: a randomized, double-blind, placebo-controlled multicenter trial. J Allergy Clin Immunol. 2013 Jan. 131(1):119-27.e1-7. [QxMD MEDLINE Link]. [Full Text].
Jones SM, Burks AW, Dupont C. State of the art on food allergen immunotherapy: oral, sublingual, and epicutaneous. J Allergy Clin Immunol. 2014 Feb. 133 (2):318-23. [QxMD MEDLINE Link]. [Full Text].
PALISADE Group of Clinical Investigators., Vickery BP, Vereda A, Casale TB, Beyer K, du Toit G, et al. AR101 Oral Immunotherapy for Peanut Allergy. N Engl J Med. 2018 Nov 22. 379 (21):1991-2001. [QxMD MEDLINE Link]. [Full Text].
Sampson HA, Aceves S, Bock SA, James J, Jones S, et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol. 2014 Nov. 134 (5):1016-25.e43. [QxMD MEDLINE Link].
Bock SA, Munoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001-2006. J Allergy Clin Immunol. 2007 Apr. 119(4):1016-8. [QxMD MEDLINE Link].
Sicherer SH, Sampson HA. Food hypersensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management. J Allergy Clin Immunol. 1999 Sep. 104(3 Pt 2):S114-22. [QxMD MEDLINE Link].
Burks AW, James JM, Hiegel A, et al. Atopic dermatitis and food hypersensitivity reactions. J Pediatr. 1998 Jan. 132(1):132-6. [QxMD MEDLINE Link].
Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA. Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998 Mar. 101(3):E8. [QxMD MEDLINE Link].
Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985 Nov. 107(5):669-75. [QxMD MEDLINE Link].
Sampson HA, Scanlon SM. Natural history of food hypersensitivity in children with atopic dermatitis. J Pediatr. 1989 Jul. 115(1):23-7. [QxMD MEDLINE Link].
Flinterman AE, Knulst AC, Meijer Y, Bruijnzeel-Koomen CA, Pasmans SG. Acute allergic reactions in children with AEDS after prolonged cow's milk elimination diets. Allergy. 2006 Mar. 61 (3):370-4. [QxMD MEDLINE Link].
Hand L. Presence of Eczema May Affect Infant Food Allergies. Medscape Medical News. Available at http://www.medscape.com/viewarticle/808060. Accessed: July 22, 2013.
Flohr C, Perkin M, Logan K, Marrs T, Radulovic S, Campbell LE, et al. Atopic Dermatitis and Disease Severity are the Main Risk Factors for Food Sensitization in Exclusively Breastfed Infants. J Invest Dermatol. 2013 Jul 18. [QxMD MEDLINE Link].
Webber CM, England RW. Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge. Ann Allergy Asthma Immunol. 2010 Feb. 104 (2):101-8; quiz 109-10, 117. [QxMD MEDLINE Link].
Furuta GT, Liacouras CA, Collins MH, Gupta SK, Justinich C, Putnam PE, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology. 2007 Oct. 133(4):1342-63. [QxMD MEDLINE Link].
Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: Updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011 Jul. 128(1):3-20.e6. [QxMD MEDLINE Link].
Powell GK. Food protein-induced enterocolitis of infancy: differential diagnosis and management. Compr Ther. 1986 Feb. 12(2):28-37. [QxMD MEDLINE Link].
Järvinen KM, Nowak-Węgrzyn A. Food protein-induced enterocolitis syndrome (FPIES): current management strategies and review of the literature. J Allergy Clin Immunol Pract. 2013 Jul-Aug. 1 (4):317-22. [QxMD MEDLINE Link].
Odze RD, Wershil BK, Leichtner AM, Antonioli DA. Allergic colitis in infants. J Pediatr. 1995 Feb. 126(2):163-70. [QxMD MEDLINE Link].
James JM. Respiratory manifestations of food allergy. Pediatrics. 2003 Jun. 111(6 Pt 3):1625-30. [QxMD MEDLINE Link].
Weber RW. Food additives and allergy. Ann Allergy. 1993 Mar. 70(3):183-90. [QxMD MEDLINE Link].
James JM, Eigenmann PA, Eggleston PA, Sampson HA. Airway reactivity changes in asthmatic patients undergoing blinded food challenges. Am J Respir Crit Care Med. 1996 Feb. 153(2):597-603. [QxMD MEDLINE Link].
Chehade M, Mayer L. Oral tolerance and its relation to food hypersensitivities. J Allergy Clin Immunol. 2005 Jan. 115(1):3-12; quiz 13. [QxMD MEDLINE Link].
Vickery BP, Scurlock AM, Jones SM, Burks AW. Mechanisms of immune tolerance relevant to food allergy. J Allergy Clin Immunol. 2011 Mar. 127(3):576-84. [QxMD MEDLINE Link].
Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol. 2012 May. 129 (5):1187-97. [QxMD MEDLINE Link].
Berin MC. Immunopathophysiology of food protein-induced enterocolitis syndrome. J Allergy Clin Immunol. 2015 May. 135 (5):1108-13. [QxMD MEDLINE Link].
Abernathy-Carver KJ, Sampson HA, Picker LJ, Leung DY. Milk-induced eczema is associated with the expansion of T cells expressing cutaneous lymphocyte antigen. J Clin Invest. 1995 Feb. 95(2):913-8. [QxMD MEDLINE Link]. [Full Text].
Commins SP, James HR, Stevens W, Pochan SL, Land MH, King C, et al. Delayed clinical and ex vivo response to mammalian meat in patients with IgE to galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2014 Jul. 134 (1):108-15. [QxMD MEDLINE Link].
Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001 Jan. 107(1):191-3. [QxMD MEDLINE Link].
Sloan AE, Powers ME. A perspective on popular perceptions of adverse reactions to foods. J Allergy Clin Immunol. 1986 Jul. 78(1 Pt 2):127-33. [QxMD MEDLINE Link].
Altman DR, Chiaramonte LT. Public perception of food allergy. J Allergy Clin Immunol. 1996 Jun. 97(6):1247-51. [QxMD MEDLINE Link].
Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007 Sep. 120(3):638-46. [QxMD MEDLINE Link].
Zuidmeer L, Goldhahn K, Rona RJ, Gislason D, Madsen C, Summers C, et al. The prevalence of plant food allergies: a systematic review. J Allergy Clin Immunol. 2008 May. 121(5):1210-1218.e4. [QxMD MEDLINE Link].
Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol. 2003 Dec. 112(6):1203-7. [QxMD MEDLINE Link].
Sicherer SH, Sampson HA. Food allergy. J Allergy Clin Immunol. 2010 Feb. 125(2 Suppl 2):S116-25.
Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011 Mar. 127(3):594-602. [QxMD MEDLINE Link].
Gupta R, Warren C, Smith B, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open. 2019 Jan 4. 2(1):
Grundy J, Matthews S, Bateman B, Dean T, Arshad SH. Rising prevalence of allergy to peanut in children: Data from 2 sequential cohorts. J Allergy Clin Immunol. 2002 Nov. 110(5):784-9. [QxMD MEDLINE Link].
Kagan RS, Joseph L, Dufresne C, Gray-Donald K, Turnbull E, Pierre YS, et al. Prevalence of peanut allergy in primary-school children in Montreal, Canada. J Allergy Clin Immunol. 2003 Dec. 112(6):1223-8. [QxMD MEDLINE Link].
Hourihane JO, Aiken R, Briggs R, Gudgeon LA, Grimshaw KE, DunnGalvin A, et al. The impact of government advice to pregnant mothers regarding peanut avoidance on the prevalence of peanut allergy in United Kingdom children at school entry. J Allergy Clin Immunol. 2007 May. 119(5):1197-202. [QxMD MEDLINE Link].
Kristen D. Jackson, M.P.H.; LaJeana D. Howie, M.P.H., C.H.E.S.; Lara J. Akinbami, M.D. Trends in Allergic Conditions Among Children: United States, 1997-2011. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Available at http://www.cdc.gov/nchs/data/databriefs/db121.pdf. 2013 May;
Wood RA. The natural history of food allergy. Pediatrics. 2003 Jun. 111(6 Pt 3):1631-7. [QxMD MEDLINE Link].
Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007 Nov. 120(5):1172-7. [QxMD MEDLINE Link].
Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol. 2007 Dec. 120(6):1413-7. [QxMD MEDLINE Link].
Savage JH, Kaeding AJ, Matsui EC, Wood RA. The natural history of soy allergy. J Allergy Clin Immunol. 2010 Mar. 125(3):683-6. [QxMD MEDLINE Link].
Mehr S, Kakakios A, Frith K, Kemp AS. Food protein-induced enterocolitis syndrome: 16-year experience. Pediatrics. 2009 Mar. 123(3):e459-64. [QxMD MEDLINE Link].
Assa'ad AH, Putnam PE, Collins MH, Akers RM, Jameson SC, Kirby CL, et al. Pediatric patients with eosinophilic esophagitis: an 8-year follow-up. J Allergy Clin Immunol. 2007 Mar. 119(3):731-8. [QxMD MEDLINE Link].
Horan RF, Sheffer AL. Food-dependent exercise-induced anaphylaxis. Immunol Allergy Clin North Am. 1991. 757.
Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS, et al. Work Group report: oral food challenge testing. J Allergy Clin Immunol. 2009 Jun. 123 (6 Suppl):S365-83. [QxMD MEDLINE Link].
Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol. 2001 May. 107(5):891-6. [QxMD MEDLINE Link].
Maloney JM, Rudengren M, Ahlstedt S, Bock SA, Sampson HA. The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy. J Allergy Clin Immunol. 2008 Jul. 122(1):145-51. [QxMD MEDLINE Link].
Sampson HA, Ho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol. 1997 Oct. 100(4):444-51. [QxMD MEDLINE Link].
Wang J, Godbold JH, Sampson HA. Correlation of serum allergy (IgE) tests performed by different assay systems. J Allergy Clin Immunol. 2008 May. 121(5):1219-24. [QxMD MEDLINE Link].
Sicherer SH, Wood RA. Advances in diagnosing peanut allergy. J Allergy Clin Immunol Pract. 2013 Jan. 1 (1):1-13; quiz 14. [QxMD MEDLINE Link].
Klemans RJ, van Os-Medendorp H, Blankestijn M, Bruijnzeel-Koomen CA, Knol EF, Knulst AC. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy: a systematic review. Clin Exp Allergy. 2015 Apr. 45 (4):720-30. [QxMD MEDLINE Link].
Lin J, Bruni FM, Fu Z, Maloney J, Bardina L, Boner AL, et al. A bioinformatics approach to identify patients with symptomatic peanut allergy using peptide microarray immunoassay. J Allergy Clin Immunol. 2012 May. 129 (5):1321-1328.e5. [QxMD MEDLINE Link].
Eigenmann PA, Sampson HA. Interpreting skin prick tests in the evaluation of food allergy in children. Pediatr Allergy Immunol. 1998 Nov. 9(4):186-91. [QxMD MEDLINE Link].
Bock SA, Lee WY, Remigio L, et al. Appraisal of skin tests with food extracts for diagnosis of food hypersensitivity. Clin Allergy. 1978 Nov. 8(6):559-64. [QxMD MEDLINE Link].
Knight AK, Shreffler WG, Sampson HA, Sicherer SH, Noone S, Mofidi S, et al. Skin prick test to egg white provides additional diagnostic utility to serum egg white-specific IgE antibody concentration in children. J Allergy Clin Immunol. 2006 Apr. 117(4):842-7. [QxMD MEDLINE Link].
Roberts G, Lack G. Diagnosing peanut allergy with skin prick and specific IgE testing. J Allergy Clin Immunol. 2005 Jun. 115(6):1291-6. [QxMD MEDLINE Link].
Nowak-Wegrzyn A, Assa'ad AH, Bahna SL, Bock SA, Sicherer SH, Teuber SS. Work Group report: oral food challenge testing. J Allergy Clin Immunol. 2009 Jun. 123(6 Suppl):S365-83. [QxMD MEDLINE Link].
Bock SA, Sampson HA, Atkins FM, et al. Double-blind, placebo-controlled food challenge (DBPCFC) as an office procedure: a manual. J Allergy Clin Immunol. 1988 Dec. 82(6):986-97. [QxMD MEDLINE Link].
Spergel JM, Brown-Whitehorn T, Beausoleil JL, Shuker M, Liacouras CA. Predictive values for skin prick test and atopy patch test for eosinophilic esophagitis. J Allergy Clin Immunol. 2007 Feb. 119(2):509-11. [QxMD MEDLINE Link].
Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. Atopy patch test for the diagnosis of food protein-induced enterocolitis syndrome. Pediatr Allergy Immunol. 2006 Aug. 17(5):351-5. [QxMD MEDLINE Link].
Mehl A, Rolinck-Werninghaus C, Staden U, Verstege A, Wahn U, Beyer K, et al. The atopy patch test in the diagnostic workup of suspected food-related symptoms in children. J Allergy Clin Immunol. 2006 Oct. 118(4):923-9. [QxMD MEDLINE Link].
Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report. J Allergy Clin Immunol. 2010 Dec. 126(6):1105-18. [QxMD MEDLINE Link].
Sicherer SH, Mahr T. Management of Food Allergy in the School Setting. Pediatrics. 2010 Dec. 126(6):1232-1239. [QxMD MEDLINE Link].
Sicherer SH, Sampson HA. Food Allergy: Recent Advances in Pathophysiology and Treatment. Annu Rev Med. 2008 Aug 19. [QxMD MEDLINE Link].
Nowak-Wegrzyn A, Sampson HA. Future therapies for food allergies. J Allergy Clin Immunol. 2011 Mar. 127(3):558-73. [QxMD MEDLINE Link].
dbv technologies. DBV Technologies Announces Results from Phase II Study of Viaskin Milk in Milk-Allergic Patients. February 26, 2018. Available at https://media.dbv-technologies.com/d286/ressources/_pdf/5/4511-PR-MILES-FINAL_ENG-PDF.pdf.
Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26. 372 (9):803-13. [QxMD MEDLINE Link].
Du Toit G, Sayre PH, Roberts G, Sever ML, Lawson K, Bahnson HT, et al. Effect of Avoidance on Peanut Allergy after Early Peanut Consumption. N Engl J Med. 2016 Apr 14. 374 (15):1435-43. [QxMD MEDLINE Link].
Fleischer DM, Sicherer S, Greenhawt M, Campbell D, Chan E, et al. Consensus Communication on Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants. Pediatr Dermatol. 2016 Jan-Feb. 33 (1):103-6. [QxMD MEDLINE Link].
Perkin MR, Logan K, Tseng A, Raji B, Ayis S, Peacock J, et al. Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants. N Engl J Med. 2016 May 5. 374 (18):1733-43. [QxMD MEDLINE Link].
Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010 Sep. 126 (3):477-80.e1-42. [QxMD MEDLINE Link].
Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26. 372 (9):803-13. [QxMD MEDLINE Link].
Hauk L. Early Peanut Introduction and Prevention of Peanut Allergy in High-Risk Infants: Consensus Communication. Am Fam Physician. 2016 Jan 1. 93 (1):61-2. [QxMD MEDLINE Link].
Lever R, MacDonald C, Waugh P, Aitchison T. Randomised controlled trial of advice on an egg exclusion diet in young children with atopic eczema and sensitivity to eggs. Pediatr Allergy Immunol. 1998 Feb. 9(1):13-9. [QxMD MEDLINE Link].
Bock SA. Respiratory reactions induced by food challenges in children with pulmonary disease. Pediatr Allergy Immunol. 1992. 3:82.
Roberts G, Patel N, Levi-Schaffer F, et al. Food allergy as a risk factor for life-threatening asthma in childhood: a case-controlled study. J Allergy Clin Immunol. 2003 Jul. 112(1):168-74.
Bock SA, Atkins FM. Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges. J Pediatr. 1990 Oct. 117(4):561-7. [QxMD MEDLINE Link].
Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics. 1987 May. 79(5):683-8. [QxMD MEDLINE Link].
Gupta RS, Springston EE, Warrier MR, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011 Jul. 128(1):e9-e17. [QxMD MEDLINE Link].
Pastorello EA, Stocchi L, Pravettoni V, et al. Role of the elimination diet in adults with food allergy. J Allergy Clin Immunol. 1989 Oct. 84(4 Pt 1):475-83. [QxMD MEDLINE Link].
Lemon-Mule H, Sampson HA, Sicherer SH, Shreffler WG, Noone S, Nowak-Wegrzyn A. Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008 Nov. 122(5):977-983.e1. [QxMD MEDLINE Link].
Greer FR, Sicherer SH, Burks AW. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008 Jan. 121(1):183-91. [QxMD MEDLINE Link].
Allen KJ, Koplin JJ, Ponsonby AL, Gurrin LC, Wake M, Vuillermin P, et al. Vitamin D insufficiency is associated with challenge-proven food allergy in infants. J Allergy Clin Immunol. 2013 Apr. 131(4):1109-1116.e6. [QxMD MEDLINE Link].
James JM, Burks AW, Roberson PK, Sampson HA. Safe administration of the measles vaccine to children allergic to eggs. N Engl J Med. 1995 May 11. 332(19):1262-6. [QxMD MEDLINE Link].
Centers for Disease Control and Prevention. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011 Aug 26. 60(33):1128-32. [QxMD MEDLINE Link].
National Institute of Allergy and Infectious Diseases. Updated recommendations on influenza vaccine and people with egg allergy. Available at http://www.niaid.nih.gov/topics/vaccines/research/Pages/eggAllergy.aspx. Accessed: September 20, 2011.
Varshney P, Jones SM, Scurlock AM, et al. A randomized controlled study of peanut oral immunotherapy: Clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol. 2011 Mar. 127(3):654-60. [QxMD MEDLINE Link].
Kim EH, Bird JA, Kulis M, Laubach S, Pons L, Shreffler W. Sublingual immunotherapy for peanut allergy: Clinical and immunologic evidence of desensitization. J Allergy Clin Immunol. 2011 Mar. 127(3):640-646.e1. [QxMD MEDLINE Link].
Thyagarajan A, Varshney P, Jones SM, et al. Peanut oral immunotherapy is not ready for clinical use. J Allergy Clin Immunol. 2010 Jul. 126(1):31-2. [QxMD MEDLINE Link]. [Full Text].
Fisher HR, du Toit G, Lack G. Specific oral tolerance induction in food allergic children: is oral desensitisation more effective than allergen avoidance?: a meta-analysis of published RCTs. Arch Dis Child. 2011 Mar. 96(3):259-64. [QxMD MEDLINE Link].
Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. The diagnosis and management of anaphylaxis: an updated practice parameter. J Allergy Clin Immunol. 2005 Mar. 115(3 Suppl 2):S483-523. [QxMD MEDLINE Link].
Begin P, Dominguez T, Wilson SP, et al. Phase 1 results of safety and tolerability in a rush oral immunotherapy protocol to multiple foods using Omalizumab. Allergy Asthma Clin Immunol. 2014 Feb 20. 10(1):7. [QxMD MEDLINE Link]. [Full Text].
Begin P, Winterroth LC, Dominguez T, et al. Safety and feasibility of oral immunotherapy to multiple allergens for food allergy. Allergy Asthma Clin Immunol. 2014 Jan 15. 10(1):1. [QxMD MEDLINE Link]. [Full Text].
Food-allergic kids need current Epi script. Medscape Medical News. November 18, 2013. [Full Text].
Hackethal V. Omalizumab Aids Desensitization to Several Food Allergies. Medscape Medical News. Feb 28 2014. [Full Text].
Johnson K. Antibiotic exposure in infancy linked to food allergies. Medscape Medical News. February 28, 2013. Available at http://www.medscape.com/viewarticle/780023. Accessed: March 4, 2013.

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Author

Scott H Sicherer, MD Professor of Pediatrics, Jaffe Food Allergy Institute, Mount Sinai School of Medicine of New York University

Scott H Sicherer, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Michael A Kaliner, MD Clinical Professor of Medicine, George Washington University School of Medicine; Medical Director, Institute for Asthma and Allergy

Michael A Kaliner, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Allergy, Asthma and Immunology, American Society for Clinical Investigation, American Thoracic Society, Association of American Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Dan Atkins, MD Assistant Professor, Department of Pediatrics, University of Colorado Health Sciences Center; Head, Division of Ambulatory Pediatrics, Department of Pediatrics, Director, Pediatric Day Program, National Jewish Medical and Research Center

Dan Atkins, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology and American Thoracic Society

Disclosure: Nothing to disclose.

Stephen C Dreskin, MD, PhD Professor of Medicine, Departments of Internal Medicine, Director of Allergy, Asthma, and Immunology Practice, University of Colorado Health Sciences Center

Stephen C Dreskin, MD, PhD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association for the Advancement of Science, American Association of Immunologists, American College of Allergy, Asthma and Immunology, Clinical Immunology Society, and Joint Council of Allergy, Asthma and Immunology

Disclosure: Genentech Consulting fee Consulting; American Health Insurance Plans Consulting fee Consulting; Johns Hopkins School of Public Health Consulting fee Consulting; Array BioPharma Consulting fee Consulting

John M James, MD Consulting Staff, Department of Pediatrics, Department of Allergy and Immunology, Colorado Allergy and Asthma Centers, PC

John M James, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma and Immunology, American Medical Association, Colorado Medical Society, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment