An expert panel sponsored by the National Institute of Allergy and Infectious Diseases has published guidelines for diagnosing and managing food allergies in the Journal of Allergy and Clinical Immunology.
Among the recommendations:
• Food allergy should be considered as a diagnosis in patients presenting with anaphylaxis or a combination of symptoms related to a food-induced allergic reaction (e.g., urticaria, wheezing, angioedema of the lips and tongue) soon after ingesting food.
• Oral food challenges remain the gold standard for diagnosing a food allergy. The panel also recommends performing a skin puncture test, along with medical history and physical examination.
• Patients with food allergies should receive nutritional counseling and be trained to read food labels.
• No medications or allergen-specific immunotherapies are recommended to prevent an allergic reaction.
• Epinephrine should be the first-line treatment in all instances of anaphylaxis. The guidelines also contain a table summarizing how best to manage anaphylaxis.
• Patients with a history of anaphylaxis should be given a prescription for two doses of an epinephrine auto-injector and instructions for use.