Symposium: Pediatric food allergy

Food allergy seems to be increasing in prevalence, significantly decreases the quality of life for patients and their families, and has become a common diagnostic and management issue for the pediatrician. Studies now a decade old showed that 6% to 8% of children younger than 3 years experience documented adverse reactions to foods. Several studies have defined the prevalence of allergy to specific foods in childhood. Population-based studies document a prevalence of cow milk allergy in 1.9% to 3.2% of infants and young children, egg allergy in 2.6% of children by age 2.5 years, and peanut allergy in 0.4% to 0.6% of those younger than 18 years. Overall, the typical allergens of infancy and early childhood are egg, milk, peanut, wheat, and soy, whereas allergens that are responsible for severe reactions in older children and adults are primarily caused by peanut, tree nuts, and seafood. Allergy to fruits and vegetables are prominent but usually not severe. For diagnostic purposes, it is instructive to consider the prevalence of food allergy as a cause of specific disorders. For example, food allergy accounts for 20% of acute urticaria, is present in 37% of children with moderate to severe atopic dermatitis and approximately 5% with atopic asthma, and is the most frequent cause of anaphylaxis outside the hospital setting.