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Results of a 16-Year Oral Food Challenges (OFC) Performed at a Major Teaching Hospital in Thailand
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Pakit Vichyanond, MD FAAAAI, Witchaya Srisuwatchari, MD
Rationale: Limited information on challenge-proven food allergy (FA) is available from Asia. We herein report our 16-year experience in OFCs performed at Siriraj hospital – the largest teaching hospital in Thailand.

Methods: From 1996-2012, 206 children had OFCs performed (total 306 OFCs). Their ages ranged from 4 months to 17 years (mean + SD 5.8 + 4.6 years). Standard OFC protocol as described Bock et al (JACI 1998) was followed with modifications made over time. 297 challenges were open with 9 being double-blinded. Clinical data, results of OFC, skin prick test (SPT) and specific IgE to foods (SpIgE) were reviewed. Descriptive statistics were used.

Results: 84 of 306 challenges were positive (27.5%) among 60 of 206 children (29%), with no preference observed among the two genders. Foods yielding positive challenges among children less than 3 years of age were wheat (30%) cow’s milk (26%), egg white (17%), and egg yolk (17%) while for those 3 years or older, shellfish was the most common food (48%) followed by wheat (20%), cow’s milk (13%), egg white (6%) and egg yolk (5%). Cutaneous reactions were most commonly observed (71%). 11.9% had multisystem involvement with anaphylaxis encountered only once. SPTs and SpIgEs were positive in 98.4% and 58% among those with positive OFCs.

Conclusions: Aside from cow’s milk and egg, wheat and shellfish are common foods giving positive challenges in this study. Only 1/3 of children studied had positive challenges emphasizing the need of OFC for a proper diagnosis of FA in Asia.