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Literature Review and Commentary 1-2017

Literature Review and Commentary 1-2017

by | Jan 1, 2024

Post Categories: Allergies | Book Reviews | Breast Health | Gut Health | Health Conditions

Is Food Allergy Testing Reliable?

Fifty-six patients with eosinophilic esophagitis underwent a six-food elimination diet. A response to the diet was defined as less than 15 eosinophils per high-power field (HPF) in esophageal biopsy samples, and a positive reaction on individual food challenges was defined as greater than 15 eosinophils per HPF. Twenty-nine patients responded to the diet and 23 completed the individual food challenges. Food triggers were identified in 20 patients, the most common being wheat (n = 10), milk (n = 9), and egg (n = 8). Five different allergy tests: skin-prick and skin-patch tests, serum allergen-specific IgE, basophil activation test, and serum food-specific IgG were performed prior to the commencement of the diet. None of these tests accurately predicted food triggers. Patch testing was always negative for foods. Serum IgG levels to food antigens were positive to two or more foods in all cases, but there was no correlation with actual food triggers. Serum IgG levels accurately predicted an individual food trigger in 13 of 20 patients, missed a food trigger in 11 of 20, and led to an over-restrictive diet in 19 of 20 patients.

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Author

Alan R. Gaby, MD

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