Oral Food Challenges Distinguish Food Sensitization from Allergy

Numerous studies suggest that many children are inappropriately labeled as allergic to specific foods. In a retrospective record review, investigators assessed the response to oral food challenges in 125 children (age range, 1–19 years; median age, 4 years) with atopic dermatitis who were referred to a major center for evaluation of food allergy. Oral food challenges were not performed in patients with a history of life-threatening reactions; a convincing history of a recent reaction; an associated large wheal size on skin prick test; or an immunoassay level above the 95% predictive value for milk, eggs, peanuts, or fish.

Among 44 children who were avoiding 111 foods because of previous positive immunoassays or skin tests, 103 (93%) food cha…