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Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital.
Allergologia et Immunopathologia ( IF 1.8 ) Pub Date : 2021-05-01 , DOI: 10.15586/aei.v49i3.103
Giulia Ballini 1 , Chiara Gavagni 2 , Caterina Guidotti 3 , Giulia Ciolini 1 , Giulia Liccioli 4 , Mattia Giovannini 4 , Lucrezia Sarti 4 , Daniele Ciofi 1, 5 , Elio Novembre 1 , Francesca Mori 4 , Simona Barni 6
Affiliation  

INTRODUCTION AND OBJECTIVE The oral food challenge (OFC) is the gold standard to diagnose food allergy (FA); however, it is not a procedure free from the risk of having significant allergic reactions, even life-threatening.The aims of our study were to evaluate the frequency of positive OFCs performed in children with a suspected diagnosis of IgE- and non-IgE-mediated (food protein-induced enterocolitis syndrome (FPIES)) FA and how the failed challenges were managed. MATERIALS AND METHODS A retrospective chart review was done on all children who have had OFCs in a tertiary-care pediatric allergy unit from 2017 to 2019. RESULTS 682 patients were enrolled and 2206 challenges were performed: 2058 (93%) for IgE-mediated FA and 148 (7%) for FPIES. There were 262 (11.8%) challenge failures. The transfer to the emergency department was required 3 times (1.1%). None of the failed challenges resulted in death or hospitalization and 13.3% challenges did not require any treatment. CONCLUSIONS Our findings confirm that food challenges can be performed safely in a specialized setting by well-trained personnel; all food challenge reactions, even the most serious, were reversible, thanks to a prompt recognition and treatment that generally did not worsen over time.

中文翻译:

三级保健儿科医院过敏科中口服食物挑战的频率及其后果。

简介和目的口服食品挑战(OFC)是诊断食物过敏(FA)的金标准;然而,这并非没有发生严重过敏反应甚至威胁生命的风险的程序。我们的研究目的是评估怀疑患有IgE和非IgE的儿童中进行阳性OFC的频率。介导的(食物蛋白引起的小肠结肠炎综合征(FPIES))FA以及如何应对失败的挑战。材料与方法自2017年至2019年,对所有在三级医疗儿科过敏科中有OFC的儿童进行了回顾性图表审查。结果招募了682例患者,进行了2206例挑战:IgE介导的FA为2058例(93%) FPIES为148(7%)。挑战失败率为262(11.8%)。要求转移到急诊室3次(1.1%)。失败的挑战均未导致死亡或住院,并且13.3%的挑战无需任何治疗。结论我们的研究结果证实,受过良好培训的人员可以在专门的环境中安全地应对食品挑战;所有的食物挑战反应,即使是最严重的反应,都是可逆的,这要归功于迅速的识别和治疗,但通常不会随着时间的流逝而恶化。
更新日期:2021-05-01
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