Oral Food Challenge Tests: A Necessary Risk

Abstract

INTRODUCTION: Food allergy has been on the rise in recent years. Its diagnosis is difficult, given the diverse pres- entations and the existence of numerous confounding factors. The oral food challenge (OFC) is the gold standard for diagnosing food allergy, however it is not without risks. Our objectives were the characterization of the population submitted to OFC in a pediatric immunoallergology unit, as well as the assessment of the risks inherent to OFC and to identify risk factors associated with the need to use a peripheral catheter.
METHODS: Descriptive, retrospective study of oral provocation tests carried out in a Pediatric Immunoalergology Unit of a level II hospital between January 2018 and December 2020.
RESULTS: Ninety PPO to different foods were analyzed: milk (39), fish (14), egg (13), dried fruit (6), fresh fruit (6), mollusks (6), shellfish (6), peanuts (3) and cocoa (1). The most frequently reported initial manifestations of food al- lergy were urticaria/angioedema (24.4%, n=22) and anaphylaxis (21%, n=19). We had 32.2% positive OFC; 51.7% of children with positive OFC had a history of asthma, rhinitis or atopic dermatitis. During the OFC there were 8 anaphylaxis, 50% of them in milk OFC.
CONCLUSION: Oral food challenges performed in a hospital environment with specialized supervision are safe, how- ever there are inherent risks to their performance. In our sample, approximately one third of patients had a positive oral challenge, however, it was not possible to identify risk factors associated with the need to use peripheral venous catheter. Prospective studies may be carried out to clarify this issue.