Medical history should be noted for the following symptoms, which may be related to food allergy.
① Recurrent eczema, urticaria, purpura and other rashes with itchy skin, related to food intake;
②Infants and children often rub their nose and eyes, repeated wheezing, frequent coughing, mistaken for respiratory tract infections, and ineffective anti-inflammatory treatment;
③Prolonged diarrhea is often thought to be an intestinal infection and treated with a large amount of anti-inflammatory drugs, causing intestinal flora disorders and aggravating allergies, while anti-inflammatory drugs can also cause allergies;
④Frequent constipation is often mistaken for fire and low water intake;
⑤ often sleep poorly, tossing and turning unsteadily when sleeping, preferring to sleep in a prone position with the buttocks puckered. They often cry paroxysmally at night and are not easily soothed. These symptoms are often mistaken for calcium deficiency and are not relieved significantly with vitamin D and calcium supplementation.
Allergy history includes a history of allergies in the child; family history of allergic diseases.
Physical examination includes signs of all systems, growth and development.
Laboratory tests include skin prick test for food allergens and serum food-specific IgE test. These 2 tests can only assist in the diagnosis of IgE-mediated food allergy. Different foods have different positive predictive values, and a positive lab test alone without a corresponding history and symptoms cannot confirm the diagnosis of food allergy.
The first four food provocation tests can basically lead to a clinical diagnosis of food allergy in children, but if the diagnosis is still unclear, food provocation tests should be performed.
When to perform a food provocation test.
① Those who have a high suspicion of food allergy and whose laboratory tests are inconclusive;
② Those who have had severe food allergies and want to resume eating after food avoidance and food replacement therapy;
(iii) Those with non-IgE-mediated food allergy;
(iv) To determine the emergence of food tolerance;
⑤ To obtain the minimum dose of food that would cause an allergic reaction in the child.
Treatment of food allergy in children
① Avoidance of the food to which the child is allergic is the most fundamental treatment;
②Symptomatic treatment of skin, respiratory and digestive system lesions, such as eczema, asthma, diarrhea and vomiting, etc;
③Serious systemic allergic reactions requiring emergency treatment, epinephrine injection is the first choice of treatment;
④Food allergy in infancy is related to the gastrointestinal barrier function and flora of infants and children, as well as the immature development of the immune system;
⑤ Attention should also be paid to cross-allergic reactions to food when choosing food, for example
Most milk allergic patients are allergic to animal dairy products such as goat’s milk, horse’s milk and camel’s milk;
Egg allergy sufferers are allergic to duck eggs, goose eggs, quail eggs, pigeon eggs and other poultry eggs;
Cod allergy sufferers are also allergic to other fish;
Shrimp allergy sufferers are allergic to shellfish, crab and other seafood;
Soy allergy sufferers may be allergic to red beans, green beans, black beans and other legumes;
Peanut allergy sufferers may be allergic to nuts such as almonds, cashews, pistachios, walnuts, etc.