Letters to the Editor
Food Challenge vs. Skin Antigen Testing
FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.
FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.
Am Fam Physician. 2002 Dec 1;66(11):2048.
to the editor: I enjoyed reading the recent review article, “Allergy Testing.”1 The article provided useful and timely information, especially with the increasing incidence of asthma and other atopic diseases in the United States. However, the article did not fully describe the relevance and benefits of testing for food allergies.
Some evidence supports Dr. Li's statements that “percutaneous skin testing … is less reliable for evaluating food allergy than for evaluating reaction to airborne allergens” and that “a double-blind food challenge should be considered when more clinical certainty is needed in diagnosing a serious food allergy.” However, evidence also suggests that hypoallergenic diets are clinically useful for patients with atopic disease. In one study,2 91 percent of 322 children placed on a hypoallergenic diet had significant improvements in asthma or allergic rhinitis; food challenges reproduced symptoms 51 percent of the time, but skin tests with food allergens rarely correlated with these results. In another trial,3 41 adults with severe asthma were randomized to either an antigen-free elemental diet or a control diet (both composed of blended food) under double-blind conditions. Patients treated with the elemental diet had significant improvement in their asthma scores.
These data support the hypothesis that food allergy is a significant component of atopic disease in some patients and also that challenge testing is superior to skin antigen testing. The diagnosis and treatment of both food and respiratory allergies is clinically useful, and we should be aware of any modalities that may benefit our patients.
1. Li JT. Allergy testing. Am Fam Physician. 2002;66:621–4.
2. Ogle KA, Bullock JD. Children with allergic rhinitis and/or bronchial asthma treated with elimination diet: a five-year follow-up. Ann Allergy. 1980;44:273.
3. Hoj L, Osterballe O, Bundgaard A, Weeke B, Weiss M. A double-blind controlled trial of elemental diet in severe, perennial asthma. Allergy. 1981;36:257–62.
Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: firstname.lastname@example.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.
Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.
Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.
Copyright © 2002 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions