In 94% of children with food allergies, the diagnosis was false

The introduction of provocation tests into clinical practice will help reduce the number of unjustified dietary restrictions and improve the quality of life of young patients, according to scientists from Sechenov University. In a study conducted jointly with the G.N. Speransky Children's City Clinical Hospital No. 9, they found out that the use of a potential allergen under the control of doctors is safe and allows to determine exactly whether a child is really allergic to this or that product. Moreover, the scientists found that laboratory diagnosis and collection of anamnesis often give false-positive results, the doctors told Izvestia.

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The researchers proposed to use as a diagnostic tool common in the world practice provocation tests. They adapted an international protocol in which a child under medical supervision consumes an allergen (milk, egg) in increasing doses.

The study participants were 130 children aged six months to 17 years with a previously established or suspected milk and/or egg allergy. Based on the results of anamnesis collection and pre-testing with blood tests and skin testing, in which the potential allergen itself was directly applied to a puncture point on the skin, children were selected for whom an open provocation test was indicated. They were then given small portions of egg or milk at 15-minute intervals in an intensive care unit setting. Doctors monitored the children for several hours after the last dose was administered.

"94% of the children were on the diet unnecessarily at the time they participated in the study. Dietary restrictions entail social restrictions - the child cannot eat with others, parents need to separately plan his diet, which requires time and additional costs. It is clear that no one will risk giving a child a potential allergen at home. But provocation tests in conditions of access to emergency care allow to safely and reliably confirm whether the child has a food allergy", - told Izvestia associate professor of the department of pediatrics and pediatric infectious diseases N.F. Filatov Sechenov University Lyudmila Fedorova.

No severe systemic allergic reactions were recorded among the children who underwent the provocation test procedure. Among the patients who were on an elimination diet due to a previously established diagnosis of food allergy or suspected food allergy, only 6% had a positive result. These children had their diagnosis of food allergy confirmed and were advised on safe alternatives in their diet.