The Role of Allergists in the Diagnosis and Management of Food Hypersensitivity
Monday, March 5, 2018
South Hall A2 (Convention Center)
Julia Thorsen, MD, MPH, Elizabeth A. Erwin, MD, Irene Mikhail, MD, Rebecca Scherzer, MD FAAAAI
RATIONALE: The prevalence of food allergy (FA) in children has increased over the past decade. Current FA testing modalities have a high false positive rate, which can lead to over-diagnosis of FA. There are limited studies that examine the referral patterns by both primary care physicians and subspecialists to allergists.

METHODS: We reviewed the charts of patients referred to the allergy clinic in a tertiary care medical center for evaluation of possible food hypersensitivity from January-February 2016. Data collected include patient demographics, results of allergy testing, and outcomes of the visit.

RESULTS: Over two-months, 194 patients were referred for possible FA and 70% completed a new patient visit. The median age was 3 years (interquartile range [1-6]) and 53% were male. Thirty-three percent of those patients had previous testing (skin testing, serum IgE levels, or both) for FA. During initial evaluation, 77% of patients had skin testing performed and 36% of patients had serum IgE levels obtained. The most common food sensitizations by skin prick testing were egg (41%), peanut (31%), tree nut (26%), and milk (24%). Sixty percent of patients had at least one other atopic co-morbidity. Eighty-seven percent of the referrals came from PCPs. Fifty-one percent of patients were discharged with concerns for an IgE-mediated hypersensitivity and 47% with self-injectable epinephrine.

CONCLUSIONS: Food allergy is a common disease of children. In this study of children referred to allergy clinic for a history concerning for food hypersensitivity, only half were instructed to avoid specific foods or required a prescription for self-injectable epinephrine.