Clinical Perspectives of Food Allergy in Infants and Young Children

Jin-Bok Hwang

doi:10.5223/kjpgn.2011.14.2.113

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Hwang: Clinical Perspectives of Food Allergy in Infants and Young Children

Invited Review

Korean Journal of Pediatric Gastroenterology and Nutrition

Korean Journal of Pediatric Gastroenterology and Nutrition 2011; 14(2): 113-121.

Published online: 30 June 2011

DOI: https://doi.org/10.5223/kjpgn.2011.14.2.113

Clinical Perspectives of Food Allergy in Infants and Young Children

Jin-Bok Hwang, M.D.

Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.

Corresponding author (pedgi@kmu.ac.kr)

Received 12 June 2011 Revised 16 June 2011 Accepted 18 June 2011

Abstract

Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.

Keywords: Food allergy, Infant, Child

Figures and Tables

Table 1

Clinical Features and Differential Diagnosis of Food Allergy in Infants and Young Children

OFC: oral food challenge, PH/AA: protein hydrolysate or amino acid formula, FPIES: food protein-induced enterocolitis syndrome, FPIPC: food protein-induced proctocolitis, GERD: gastroesophageal reflux disease.

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