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Clinical Manifestations of Pediatric Food Allergy: a Contemporary Review

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Abstract

Food allergies (FAs) are an emerging health care issue, and a “second wave of the allergy epidemic” was named. There are extensive data that documented the prevalence rate as high as approximately 10%. FAs are immunological adverse reactions, including IgE-mediated mechanisms, cell-mediated mechanisms, or mixed IgE- and cell-mediated mechanisms. A diagnosis of FA is made by specific symptoms encounter with food, detailed past history, sensitization tests, and oral food challenges (OFCs) if necessary. The component-resolved diagnostics (CRD) test can distinguish true or cross-reaction. “Minimal elimination” from the results of CRD and OFC could avoid unnecessary food restriction. Strict food limitation is harsh and stressful on patients and their families. Children with FAs experience a higher rate of post-traumatic stress symptoms (PTSS) and bullying than others. In the last 20 years, oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) are treatment strategies. OIT and EPIT are the most two encouraging treatments for FA. This review aims to introduce FAs in diverse clinical disorders, new perspectives, and their practical implications in diagnosing and treating FA.

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Acknowledgements

I sincerely appreciate Professor Bor-Luen Chiang, who encourages me to write this review article and he has always served as a mentor to me in the field of allergy. I would like to express my deep gratitude to Professor Motohiro Ebisawa, who gave me the opportunity to learn about the field of food allergy, as well as the staff members in the Department of Allergy, Clinical Research Center for Allergology and Rheumatology in Sagamihara National Hospital, for their kindness and teaching. I would give my heartfelt thanks to Dr. Ichiro Nomura for his permission to use and modify the figure. I also give my thanks to Dr. Chun-Min Kang for the correction of tables and figures.

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Authors and Affiliations

  1. Department of Pediatrics, Shin Kong WHS Memorial Hospital, Taipei, Taiwan

    Ling-Jen Wang, Shu-Chi Mu, Ming-I. Lin, Tseng-Chen Sung & Cheng-Hui Lin

  2. School of Medicine, Fu-Jen Catholic University, Taipei County, Taiwan

    Ling-Jen Wang & Shu-Chi Mu

  3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

    Shu-Chi Mu

  4. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan

    Bor-Luen Chiang

  5. Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan

    Bor-Luen Chiang

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Wang, LJ., Mu, SC., Lin, MI. et al. Clinical Manifestations of Pediatric Food Allergy: a Contemporary Review. Clinic Rev Allerg Immunol 62, 180–199 (2022). https://doi.org/10.1007/s12016-021-08895-w

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