Diagnostic Algorithm of Food Allergy at the Child Age
Authors:
M. Jeseňák 1,2; Z. Havlíčeková 1; J. Buchanec 1; M. P. Villa 2; R. Ronchetti 2; P. Bánovčin 1
Authors‘ workplace:
Klinika detí a dorastu, Univerzita Komenského, Jesseniova lekárska fakulta, Martin
prednosta prof. MUDr. P. Bánovčin, CSc.
1; Clinica Pediatrica, Universita „La Sapienza“, Ospedale Sant’Andrea, Via Grottarossa, Rome, Italy
prednosta prof. M. P. Villa, MD., PhD.
2
Published in:
Čes-slov Pediat 2008; 63 (5): 272-282.
Category:
Postgraduate Education
Overview
Diagnostics of food allergy (FA) belongs to complicated matters of child immunoallergology and gastroenterology. Clinical diagnosis is established on the basis of results of individual standardized methods in vivo as well as in vitro. FA is based on immunological grounds and the specialist should uncover them.
The diagnostics of FA in clinical practice is based on a panel of standardized examinations which include: the determination of specific IgEs against food allergens, skin prick tests and atopic patch tests, elimination diets and oral load tests. In addition to these tests there is a group of other examinations which could soon become the part of standardized algorithms for FA: the test of activation and degranulation of basophiles and some new markers of allergic inflammation in stools, blood or urine (eosinophil protein X, eosinophil cationic protein, tryptase, α1-antitrypsin, leukotriene E4, eotaxin, TNF-α, histamine, methyl-histamine). On the other hand there is a group of diagnostic procedures of speculative nature which should not be further recommended as suitable methods (e.g. skin application food tests, labial load test, the determination of specific antibodies of class IgG, sublingual and intradermal provocation/neutralization tests, cytotoxic tests, applied kinesiology, electrodermal testing, etc.).
Diagnostics and therapy of food allergy belongs exclusively into the hands of an experienced specialist (child gastroenterologist in cooperation with immuno-allergologist and dermatologist) with extensive experience in interpretation of results of individual methods of examination, which are the basis for subsequent indication of a therapeutic diet or other therapeutic procedures.
Key words:
atopic patch tests, diagnostic algorithm, child, elimination diet, skin prick tests, oral load tests, food allergy, specific IgEs, standardized tests
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2008 Issue 5
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