TOPLINE:

In a study of 200 children with suspected or confirmed immunoglobulin E (IgE)-mediated food allergies, oral food challenges (OFCs) proved essential for diagnosis, while both asthma and prior food-induced anaphylaxis independently predicted failure of OFCs.

METHODOLOGY:

• Researchers retrospectively reviewed charts of 205 cases with standard-of-care OFCs conducted between January 1, 2014, and September 30, 2024, to assess outcomes and predictors of severe symptoms in OFCs.
• They focused on 200 children (mean age, 5.7 years; 65.9% boys) with suspected or diagnosed IgE-dependent food allergies who underwent OFCs for foods including cow’s milk protein, nuts, gluten, hen’s egg white protein, and yolk.

TAKEAWAY:

• The overall failure rate for OFCs was 32.2%, with five (2.4%) yielding inconclusive results.
• Cow’s milk protein was the most frequently challenged allergen, representing 50.2% (103) of all OFCs, followed by hen’s egg white protein (41.0%; 84 OFCs).
• Asthma (P = .03) and multiple food allergies (P = .02) were significant predictors of OFC failure.
• Only four patients required epinephrine administration for grade 4 or 5 reactions.

IN PRACTICE:

“Importantly, we identified asthma and multiple food allergies as significant risk factors for OFC failure,” the authors of the study wrote. “These results underscore the need for heightened caution and individualized risk assessment when considering OFCs in children with these conditions,” they added.

SOURCE:

Urszula Jedynak-Wąsowicz, with the Jagiellonian University Medical College, Kraków, Poland, was the corresponding author of the study, which was published online on August 27 in Nutrients.

LIMITATIONS:

This study was limited by its small sample size and single-center retrospective design. Additionally, component-resolved diagnostics for food allergies were not routinely performed and were available only for a subset of children.

DISCLOSURES:

The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.