Rationale:
Allergy tests (specific IgE) for foods alone cannot determine whether a child is truly allergic. Both panel tests and specific IgE for individual allergens can yield positive results even in children without allergies. Testing without proper clinical indications can lead to misdiagnosis, unnecessary dietary restrictions, and potential nutritional deficiencies or growth impairment.
Indications for testing:
1) Typical symptoms of immediate-type allergy occurring minutes to hours after food intake. In such cases, only the relevant allergen should be tested, or a panel may be considered if the specific allergen is unknown.
2) Moderate to severe atopic eczema. Panels may be used for screening, but results must be interpreted cautiously.
References:
- Bird JA, et al. Food allergen panel testing often results in misdiagnosis of food allergy. J Pediatr. 2015; 166: 97-100.
- NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol 2010; 126: S1-58.
- Noimark, L. et al. Nutritional problems related to food allergy in childhood. Pediatric Allergy and Immunology, 2008; 19:188–195.
- Alvares, M. et al. Misdiagnosed food allergy resulting in severe malnutrition in an infant. Pediatrics 2013; 132: e229–e232.