Oral food challenge to peanut

Food allergy is a very common and even popular disease to have.  This results in some predictable patient behavior such as:

1.       I have allergy based on a blood test only, and I tolerate this food all the time.  This may not be allergy at all, but simply a condition called “asymptomatic hypersensitivity”.  Relax, some foods you can eat without allergy symptoms even though a blood or skin test is positive. 

2.       It is fashionable nowadays to have gluten sensitivity.  Many patients will perform gluten challenges at home to see if bread or starches make abdominal cramping, skin rashes, or even concentration problems improve or worsen with the offending food.  This practice becomes a problem if you are concerned with anaphylaxis (difficulty breathing, low blood pressure) to foods such as peanut, milk, or eggs to name a few.  It’s one thing to experience more abdominal bloating after a gluten challenge and a much more dangerous situation to lose consciousness after ingesting peanut. 

3.       I’m grateful to be a member of the American Academy of Allergy, Asthma, and Immunology (AAAAI) in part because they help me as an allergist to stay current of all the thousands of recommendations published every year on my specialty.   One such service is “Ask the Expert” forum and I’d like to share a recent post with you about food challenges.

Here’s the take-home message and the full answer is available if you click on the link below:

1.       Food anaphylaxis can be related to the total amount of food ingested.  In other words, don’t assume that tolerating a very small amount of peanut will guarantee that you can tolerate peanuts ad lib!  Food challenges are performed under close supervision in order to determine HOW sensitive you are. 

2.       Oral desensitization to foods is still in the research stage and the experts on treating food allergy do not recommend this procedure be performed outside of a research protocol.  It only takes one bad outcome to taint any progress made with treatment of food anaphylaxis.

Anyway, it’s lunchtime, and talking about food does make me hungry!

Oral food challenge to peanut.

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