Venter Carina, Halken Susanne, Toniolo Alice, Nowak-Wegrzyn Anna, Vlieg-Boerstra Berber, Nilsson Caroline A, Fleischer David M, de Silva Debra, Barber Domingo, Khaleva Ekaterina, Knol Edward, Protudjer Jennifer L P, Morandini Laura, Muraro Antonella
University of Colorado, Aurora, Colo.
Children's Hospital Colorado, Aurora, Colo.
J Allergy Clin Immunol Glob. 2025 Aug 18;4(4):100556. doi: 10.1016/j.jacig.2025.100556. eCollection 2025 Nov.
People suspected of food allergy require accurate diagnosis to help manage their condition and get appropriate care. Recent guidelines summarize the latest evidence about diagnosing IgE-mediated food allergy, but they do not describe how to address practical issues when testing. There is a need to translate guideline recommendations into a practical common pathway that all centers dealing with food allergy can use.
The Global Network of Centres of Excellence for Anaphylaxis & Food Allergy-ANAcare developed a pathway to help clinicians apply the latest diagnostic guidelines and overcome implementation challenges.
The pathway is based on reviewing guidelines, research and clinical feedback, plus consensus of experts from 13 countries.
We describe practical tips that clinicians can use when taking a detailed clinical history and testing people with suspected IgE-mediated food allergy. Tests for IgE sensitization such as skin prick tests and specific IgE are readily available and inexpensive. However, they only demonstrate sensitization, not clinical allergic disease, so they need to be interpreted in the context of the clinical history. A controlled oral food challenge may also be needed to identify which foods the person is experiencing reactions to and what quantity can be tolerated.
Correct diagnosis is essential to support individualized management. Allergy centers around the world can use our practical tips to help avoid under- and overdiagnosis.
疑似食物过敏的患者需要准确诊断，以帮助控制病情并获得适当护理。近期指南总结了有关IgE介导的食物过敏诊断的最新证据，但未描述检测时如何解决实际问题。有必要将指南建议转化为所有处理食物过敏的中心都可采用的实用通用路径。
全球过敏与食物过敏卓越中心网络（ANAcare）制定了一条路径，以帮助临床医生应用最新诊断指南并克服实施挑战。
该路径基于对指南、研究和临床反馈的审查，以及来自13个国家的专家共识。
我们描述了临床医生在详细询问临床病史和检测疑似IgE介导的食物过敏患者时可使用的实用技巧。IgE致敏检测，如皮肤点刺试验和特异性IgE检测，易于进行且成本低廉。然而，它们仅能证明致敏情况，而非临床过敏性疾病，因此需要结合临床病史进行解读。可能还需要进行口服食物激发试验，以确定患者对哪些食物有反应以及能耐受的量。
正确诊断对于支持个体化管理至关重要。世界各地的过敏中心可以利用我们的实用技巧，以避免诊断不足和过度诊断。
