Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups
Abstract Background Oral food challenges (OFCs) are used to confirm or reject a diagnosis of food allergy. However, younger children may encounter difficulties in consuming all offered doses during an OFC in the absence of symptoms, resulting in inconclusive outcomes. Our aim is to assess the elicit...
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Wiley
2024-01-01
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| Series: | Immunity, Inflammation and Disease |
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| Online Access: | https://doi.org/10.1002/iid3.1152 |
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| author | Wouter W. deWeger Diede Jansen Lidy vanLente Gerbrich N. van derMeulen Arvid W. A. Kamps |
| author_facet | Wouter W. deWeger Diede Jansen Lidy vanLente Gerbrich N. van derMeulen Arvid W. A. Kamps |
| author_sort | Wouter W. deWeger |
| collection | DOAJ |
| description | Abstract Background Oral food challenges (OFCs) are used to confirm or reject a diagnosis of food allergy. However, younger children may encounter difficulties in consuming all offered doses during an OFC in the absence of symptoms, resulting in inconclusive outcomes. Our aim is to assess the eliciting dose for objective symptoms among various age groups and determine the necessity of consuming the final dose step during an uneventful OFC to avoid false negative outcomes. Methods OFCs for common food allergens performed between 2012 and 2019 were analyzed retrospectively. The primary outcome was the association of age with stop dose for OFCs with inconclusive outcome. Secondary outcome measures were the association of age with eliciting dose and the potential number of false negative outcomes. Results A total of 1327 OFCs were performed in 707 patients. Of these, 514 (38.7%) were positive, 589 (44.4%) negative, and 224 (16.9%) inconclusive. In OFCs with inconclusive outcome, age appeared to be a significant predictor of the stop dose only for almond (p = .005). Objective symptoms occurred after the last dose step in 2%–13% of all OFCs with positive outcome. In our cohort, potential false negative outcomes may have been drawn in 27.6% of uneventful OFCs. Conclusions Two third of children under 6 years of age successfully consumed all the provided doses during OFCs with a negative outcome. The eliciting dose for objective symptoms was not associated with age, and in a substantial number of OFCs with positive outcome, symptoms occurred after eating the final dose. These findings suggest that in case of an uneventful OFC, the outcome should be drawn only after a cumulative dose of 4.4 g has been consumed to avoid the risk of a potential false negative outcome. |
| format | Article |
| id | doaj-art-e13fdc10e22c49db8686d478a47e67bf |
| institution | Kabale University |
| issn | 2050-4527 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Immunity, Inflammation and Disease |
| spelling | doaj-art-e13fdc10e22c49db8686d478a47e67bf2025-08-20T03:30:37ZengWileyImmunity, Inflammation and Disease2050-45272024-01-01121n/an/a10.1002/iid3.1152Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groupsWouter W. deWeger0Diede Jansen1Lidy vanLente2Gerbrich N. van derMeulen3Arvid W. A. Kamps4Department of Paediatrics Martini Hospital Groningen The NetherlandsDepartment of Paediatrics Martini Hospital Groningen The NetherlandsDepartment of Epidemiology Martini Hospital Groningen The NetherlandsDepartment of Paediatrics Martini Hospital Groningen The NetherlandsDepartment of Paediatrics Martini Hospital Groningen The NetherlandsAbstract Background Oral food challenges (OFCs) are used to confirm or reject a diagnosis of food allergy. However, younger children may encounter difficulties in consuming all offered doses during an OFC in the absence of symptoms, resulting in inconclusive outcomes. Our aim is to assess the eliciting dose for objective symptoms among various age groups and determine the necessity of consuming the final dose step during an uneventful OFC to avoid false negative outcomes. Methods OFCs for common food allergens performed between 2012 and 2019 were analyzed retrospectively. The primary outcome was the association of age with stop dose for OFCs with inconclusive outcome. Secondary outcome measures were the association of age with eliciting dose and the potential number of false negative outcomes. Results A total of 1327 OFCs were performed in 707 patients. Of these, 514 (38.7%) were positive, 589 (44.4%) negative, and 224 (16.9%) inconclusive. In OFCs with inconclusive outcome, age appeared to be a significant predictor of the stop dose only for almond (p = .005). Objective symptoms occurred after the last dose step in 2%–13% of all OFCs with positive outcome. In our cohort, potential false negative outcomes may have been drawn in 27.6% of uneventful OFCs. Conclusions Two third of children under 6 years of age successfully consumed all the provided doses during OFCs with a negative outcome. The eliciting dose for objective symptoms was not associated with age, and in a substantial number of OFCs with positive outcome, symptoms occurred after eating the final dose. These findings suggest that in case of an uneventful OFC, the outcome should be drawn only after a cumulative dose of 4.4 g has been consumed to avoid the risk of a potential false negative outcome.https://doi.org/10.1002/iid3.1152allergyprocesses |
| spellingShingle | Wouter W. deWeger Diede Jansen Lidy vanLente Gerbrich N. van derMeulen Arvid W. A. Kamps Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups Immunity, Inflammation and Disease allergy processes |
| title | Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| title_full | Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| title_fullStr | Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| title_full_unstemmed | Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| title_short | Eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| title_sort | eliciting and stop dose during oral food challenges for peanut and common tree nuts in different age groups |
| topic | allergy processes |
| url | https://doi.org/10.1002/iid3.1152 |
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