Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Allergy Asthma Clin Immunol. 2009 Oct 22;5(1):2. doi: 10.1186/1710-1492-5-2.
Food allergy is a serious and potentially life-threatening problem for an estimated 6% of children and 3.7% of adults. This review examines the diagnostic process that begins with a patient's history and physical examination. If the suspicion of IgE-mediated food allergy is compelling based on the history, skin and serology tests are routinely performed to provide confirmation for the presence of food-specific IgE antibody. In selected cases, a provocation challenge may be required as a definitive or gold standard reference test for confirmation of IgE mediated reactions to food. Variables that influence the accuracy of each of the diagnostic algorithm phases are discussed. The clinical significance of food allergen-specific IgE antibody cross-reactivity and IgE antibody epitope mapping of food allergens is overviewed. The advantages and limitations of the various diagnostic procedures are examined with an emphasis on future trends in technology and reagents.
食物过敏是一个严重且潜在威胁生命的问题，据估计，儿童中约有 6%，成人中约有 3.7%受到影响。本文综述了从患者病史和体格检查开始的诊断过程。如果根据病史强烈怀疑 IgE 介导的食物过敏，通常会进行皮肤和血清学检查，以提供食物特异性 IgE 抗体存在的确认。在某些情况下，激发挑战可能作为 IgE 介导的食物反应的明确或金标准参考测试是必要的。讨论了影响诊断算法各阶段准确性的变量。本文综述了食物过敏原特异性 IgE 抗体交叉反应性和食物过敏原 IgE 抗体表位图谱的临床意义。检查了各种诊断程序的优缺点，并重点关注技术和试剂的未来发展趋势。
