• Cornelia S Seitz, Petra Pfeuffer, Petra Raith, Eva-B Bröcker, and Axel Trautmann.
• Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie der Universität Würzburg.
• Dtsch Arztebl Int. 2008 Oct 1; 105 (42): 715723715-23.

Background10% to 20% of the population sees itself as suffering from food allergy, yet genuine, immune-mediated food allergy is suspected by patients and their physicians far more often than it is actually shown to be present. The unfounded suspicion of an IgE-mediated food allergy can substantially impair a patient's quality of life through needless dietary restriction and the accompanying anxiety. On the other hand, an IgE-mediated food allergy that has gone undiagnosed or that has not been taken seriously can manifest suddenly with anaphylaxis, which may be life-threatening. The present study, carried out on a large cohort of patients, underscores the importance of differentiating IgE-mediated food allergy from other, nonallergic types of food reaction.Methods419 patients that had been referred to our outpatient allergy clinic for suspected food allergies underwent a standardized allergological diagnostic evaluation, including thorough allergologic history-taking, IgE serology, and challenge tests when indicated.Results214 patients (51.1%) were found to have an IgE-mediated food allergy. Almost half of these patients (24.3% of the overall group) had previously experienced food-induced anaphylaxis. In 205 patients (48.9%), however, an IgE-mediated food allergy was ruled out as far as possible.ConclusionOnly a comprehensive allergological evaluation performed by an experienced allergologist in accordance with current guidelines can protect patients from the negative consequences of excessive concern about a nonexistent food allergy (e.g., needless dietary restriction) or, on the other hand, the negative consequences of inadequate attention to a genuine food allergy (anaphylaxis). A proper evaluation consists of detailed allergologic history-taking, skin tests, and challenge tests when indicated.

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