Korean J Pediatr Gastroenterol Nutr.  2010 Dec;13(Suppl 1):S32-S43. 10.5223/kjpgn.2010.13.Suppl1.S32.

The Diagnosis of Food Allergy in a Pediatric Gastroenterology: Focusing on Non-IgE-mediated Allergic Diseases

• Lee KS

• KMID: 2275464
• DOI: http://doi.org/10.5223/kjpgn.2010.13.Suppl1.S32

Abstract

Food allergy is an adverse immune response to foods. The prevalence of food allergy vary by age, diet, and many other factors. Based on the immunological mechanism, food allergies may be classified in a IgE-mediated diseases, which are the best-characterized food allergy reactions, non-IgE-medicated diseases, and mixed type diseases. In children, the GI tract seems to be the most common target organ. Generally, IgE-mediated reactions have an acute onset, whereas non-IgE-mediated reactions have a late onset. The most food allergy with GI manifestation involve non-IgE-mediated reactions. The evaluation of a child with suspected food allergy includes medical history, physical examination, screening test and the response to elimination diet and to oral food challenge. The diagnosis of non-IgE-mediated food allergies using a screening test is difficult. In this review, investigate the diagnostic criteria and manifestations of several non-IgE-mediated allergic diseases and the diagnostic method in the field of a pediatric gastroenterology.

Keyword

Food allergy; Non-IgE-mediated reactions; Pediatric gastroenterology

MeSH Terms

Child
Diet
Food Hypersensitivity
Gastroenterology
Gastrointestinal Tract
Humans
Mass Screening
Physical Examination
Prevalence

Figure

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  Fig. 1 Evaluation of a child with suspected food allergy.

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  Fig. 2 Measurement for skin prick test.

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  Fig. 3 Procedures for diagnosis of eosinophilic esophagitis.

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  Fig. 4 Algorithm after oral cow's milk challenge for diagnosis of typical cow's milk protein-induced enterocolitis. Adapted from ref. 26.

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  Fig. 5 Selection of type of food challenge according to age and symptoms. Adapted from ref. 22.

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