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World J Clin Pediatr. May 9, 2022; 11(3): 253-269
Published online May 9, 2022. doi: 10.5409/wjcp.v11.i3.253
Food allergy in children—the current status and the way forward
Ahmed Elghoudi, Hassib Narchi
Ahmed Elghoudi, Paediatric Department, Sheikh Khalifa Medical City, Abu Dhabi NA, Abu Dhabi, United Arab Emirates
Ahmed Elghoudi, Hassib Narchi, College of Medicine and Health Sciences, United Arab Emirates University, Alain, Abu Dhabi, United Arab Emirates
Author contributions: Elghoudi A and Narchi H wrote the paper, revised it, and approved the final submitted version.
Conflict-of-interest statement: The authors declare that the review article was written in the absence of any financial conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Elghoudi, FRCP, MSc, Doctor, Paediatric Department, Sheikh Khalifa Medical City, Al Karama Street, Abu Dhabi, United Arab Emirates. ahmed.elghoudi1@gmail.com
Received: April 6, 2021
Peer-review started: April 6, 2021
First decision: July 6, 2021
Revised: July 16, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 9, 2022
Processing time: 395 Days and 19.5 Hours
Abstract

Food allergy in children is a major health concern, and its prevalence is rising. It is often over-diagnosed by parents, resulting occasionally in unnecessary exclusion of some important food. It also causes stress, anxiety, and even depression in parents and affects the family’s quality of life. Current diagnostic tests are useful when interpreted in the context of the clinical history, although cross-sensitivity and inability to predict the severity of the allergic reactions remain major limitations. Although the oral food challenge is the current gold standard for making the diagnosis, it is only available to a small number of patients because of its requirement in time and medical personnel. New diagnostic methods have recently emerged, such as the Component Resolved Diagnostics and the Basophil Activation Test, but their use is still limited, and the latter lacks standardisation. Currently, there is no definite treatment available to induce life-long natural tolerance and cure for food allergy. Presently available treatments only aim to decrease the occurrence of anaphylaxis by enabling the child to tolerate small amounts of the offending food, usually taken by accident. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy. If standardised and widely implemented, this may result in decreasing the prevalence of food allergy.

Keywords: Oral food challenge; Oral immunotherapy; Allergens; Anaphylaxis; Desensitisation; Immunoglobulin E; Eosinophilic gastrointestinal diseases; Histamine; Mast cells; Basophil activation test

Core Tip: Food allergy in children is a potentially serious condition with an increasing prevalence. Current diagnostic tests are useful when interpreted in the context of the clinical history. The oral food challenge is the current gold standard for making the diagnosis, but its use is limited. New diagnostic methods have recently emerged. Currently, there is no definite treatment to induce life-long natural tolerance and cure for this condition, and available treatments only aim to decrease the occurrence of anaphylaxis. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy.