Adverse Reactions to Food

Food allergies appear to have increased worldwide. Most food allergic reactions in early childhood are caused by hen’s eggs, cow’s milk, peanuts, tree nuts, wheat, soy, fish, and sesame. Symptoms are heterogeneous and can involve every organ system. In hen’s eggs, cow’s milk, wheat, and soy allergy, natural tolerance develops frequently, whereas peanut and tree nut allergy is often persistent. In the pathogenesis, genetic and environmental factors are involved and an impaired barrier function of the skin seems to have an important role. Diagnosing food allergy is challenging and molecular diagnostics have shown to be helpful but the reference standard remains the oral food challenge. Management strategies in food allergy include an elimination diet, and medical treatment in case of accidental allergen ingestion. Adequate education for both is crucial. Immunotherapeutic approaches are promising but currently not recommended for routine clinical use.