Table E1. Food Allergic Disorders Disorder Key features Additional Typical age Most Common Natural Diagnostic Causal foods Course Considerations (in addition to history, possible food challenges) IgE antibody dependent, (acute onset) Triggered by ingestion or Children > Primarily Depending SPT and/or sIgE “major by direct skin contact adults allergens” egg, upon food (contact urticaria). Food milk, wheat, commonly causes acute soy, peanut, (20%) but rarely chronic tree nuts, fish, (2%) urticaria. shellfish Oral allergy Pruritus, mild edema Sensitization Onset after Raw May be SPT and/or sIgE syndrome confined to oral cavity. to pollen pollen allergy long-lived Fresh (raw) proteins by established Cooked forms and vary Uncommonly progresses testing the (Adult> young tolerated. with beyond mouth (~7%) or food allergy respiratory child). Examples of seasons anaphylaxis (1-2%). syndrome) route results relationships: in IgE that Birch (apple, May increase following binds certain peach, pear, pollen season. homologous, carrot), typically Ragweed labile, food (melons). proteins (in
Table E1. Food Allergic Disorders Disorder Key features Additional Typical age Most Common Causal foods Natural Course Diagnostic Considerations (in addition to history, possible food challenges) IgE antibody dependent, (acute onset) Triggered by ingestion or by direct skin contact (contact urticaria). Food commonly causes acute (20%) but rarely chronic (2%) urticaria. Children > adults Primarily “major allergens” egg, milk, wheat, soy, peanut, tree nuts, fish, shellfish Depending upon food SPT and/or sIgE Oral allergy syndrome food allergy syndrome) Pruritus, mild edema confined to oral cavity. Uncommonly progresses beyond mouth (~7%) or anaphylaxis (1-2%). May increase following pollen season. Sensitization to pollen proteins by the respiratory route results in IgE that binds certain homologous, typically labile, food proteins (in Onset after pollen allergy established (Adult> young child). Raw Cooked forms tolerated. Examples of relationships: Birch (apple, peach, pear, carrot), Ragweed (melons). May be long-lived and vary with seasons SPT and/or sIgE Fresh (raw) testing