• Singap Med J · Nov 2015

    A review of oral food challenges in children presenting to a single tertiary centre with perceived or true food allergies.

    • Meera Thalayasingam, Evelyn Xiu Ling Loo, Michelle Meiling Tan, BeverHugo VanHVDepartment of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore., and Lynette Pei-Chi Shek.
    • Department of Paediatrics, International Medical University Clinical School Seremban, Malaysia.
    • Singap Med J. 2015 Nov 1; 56 (11): 622-5.

    IntroductionThe prevalence of perceived food allergies exceeds that of true food allergies. Unnecessary food avoidance may increase parental and patient anxiety, reduce quality of life and increase the risk of nutritional deficiency. An oral food challenge (OFC) can provide an objective measure regarding the presence or absence of food allergies in a child. This study reviews the indications for and outcomes of OFCs performed on children.MethodsA retrospective review was performed on all children who underwent OFCs at the Allergy Unit of the National University Hospital, Singapore, over a three-year period.ResultsA total of 197 OFCs were performed among 58 patients (34 male, 24 female). Most of the tests were for allergies to tree nuts (n = 107). Among the OFCs, 43.1% were for foods that were avoided and never eaten due to perceived food allergies, 25.9% were for foods that had previously resulted in positive skin prick tests (SPTs) and/or immunoassay results, 16.2% were for foods thought to worsen eczema and 14.7% were for foods thought to have caused a previous reaction. Of all the OFCs, 5% were positive, although adverse reactions were mostly cutaneous. Challenge-positive patients had either positive SPTs (wheal > 3 mm) or raised serum immunoglobulin E levels to specific foods that they reacted to during the challenges. No episodes of anaphylaxis were reported after the challenge. Most of the patients were able to safely introduce the avoided foods into their diets.ConclusionOFCs provide an objective assessment for suspected food allergies.

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