← Blog

Food Allergy Diagnosis: Skin Prick Tests, Specific IgE, and Oral Challenge for Anaphylaxis Management

A Hispanic pediatric allergist in a white coat and warm smile explains the prick test procedure to an 8-year-old Hispanic boy in a modern medical examination room. The boy, sitting on the examination table, displays curiosity and slight nervousness. In the background, allergen vials are visible, creating a professional and welcoming atmosphere that emphasizes the importance of accurate food allergy diagnosis, including specific IgE testing and oral challenge tests, to prevent anaphylaxis.

The food allergy diagnosis is a complex process that requires a combination of detailed clinical history and specific diagnostic tests. Skin prick tests and oral challenge tests are fundamental tools in this process, especially for IgE-mediated allergies. Food allergies, which affect both children and adults, can manifest with symptoms ranging from mild to potentially life-threatening, such as anaphylaxis.

Diving Deeper into Diagnosis

Skin prick tests, such as the prick test, are widely used to assess sensitization to food allergens. These tests are quick and provide valuable information about the presence of specific IgE in the patient's skin. However, it is important to remember that a positive result indicates sensitization, not necessarily a clinical allergy. The systematic review by EAACI highlights the high sensitivity of skin tests for certain foods like cow's milk and egg [1].

On the other hand, the oral challenge test is considered the gold standard for diagnosing food allergies. This procedure, which must be performed under strict medical supervision, allows for the confirmation or exclusion of a food allergy by observing the patient's reaction after the controlled ingestion of the suspected food. According to the guidelines from AAAAI and EAACI, the oral challenge is essential in cases where skin tests and specific IgE levels are inconclusive [2].

Furthermore, the update on conducting oral challenges emphasizes the importance of considering factors such as safety, treatment of IgE-mediated allergic reactions, and psychosocial considerations for patients and their families [3].

Conclusions

Accurate diagnosis of food allergies is crucial to avoid unnecessary dietary restrictions and prevent severe allergic reactions. Skin prick tests and oral challenge tests are complementary tools that, when used appropriately, can provide reliable diagnoses. It is essential for healthcare professionals to stay updated on the latest guidelines and studies to optimize the management of food allergies in their patients.

References


Created 2/1/2025