All issues > Volume 47(3); 2004

Clinical Lecture

Korean J Pediatr. 2004;47(3):240-246. Published online March 15, 2004.

Food Allergy

Soo-Young SY Lee¹

¹Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea

Correspondence Soo-Young SY Lee ,Email: jsjs87@madang.ajou.ac.kr

Abstract

Food allergy is one of the clinical clusters due to food-induced allergic inflammation against dietary proteins which induced by IgE-mediated and/or non-IgE mediated mechanisms. Food allergic reactions are responsible for a variety of clinical symptoms involving the skin, gastrointestinal tract, and respiratory tract. Sometimes the life threatening anaphylactic reactions would be induced, especially by peanuts, tree nuts and buckwheat allergy. Up to 8% of children less than 3 years of age, and up to 2% of adult population experienced food allergic diseases. A limited number of foods are responsible for the vast majority of food allergic reactions in clinically. Cow's milk, egg, soybean, peanuts, tree nuts, fish, shellfish are the major allergenic foods. Especially in infant and young children, the IgE sensitization to cow's milk, egg, and soybeans are most prevalent, and buckwheat allergy is relatively frequent in Asian countries including Korea. Proper diagnoses often require screening tests for evidence of food-specific IgE(Skin prick test, detection of serum allergen specific IgE over cut- off values) and proof of reactivity through elimination diets and oral food challenges. Recently, the diagnostic decision points of serum specific IgE levels were defined for several kinds of food allergies(egg white, cow's milk, soybeans, peanut, wheat, fish, buckwheat), and the use of these optimal cutoff levels would be helpful for avoiding unnecessary risky challenge in children with a strong clinical history and skin test responses. Once food allergy is properly diagnosed, strict avoidance of the implicated food(s) and containing products is the only proven form of treatment. Clinical or immunilogical tolerance to food allergens will develop in many patients over time(usually need more than 3 years of strict avoidance), and therefore follow-up serologic tests and/or food challenges are often indicated for avoiding unnecessary long term duration of avoidance in cases.

Keywords :Food allergy, Food allergens, Diagnosis, Tolerance