Format

Send to

Choose Destination
Clin Exp Allergy. 2020 Jan 19. doi: 10.1111/cea.13572. [Epub ahead of print]

Reintroduction failure after negative food challenges in adults is common and mainly due to atypical symptoms.

Author information

1
Department of Dermatology/Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands.
2
Department of Pediatric Pulmonology and Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands.
3
Department of Health Care, Saxion University of Applied Sciences, Enschede, The Netherlands.

Abstract

BACKGROUND:

Reintroduction of a food after negative food challenge (FC) faces many obstacles. There are no studies available about this subject in adults.

OBJECTIVE:

To investigate the frequency, reasons and risk factors of reintroduction failure in adults.

METHODS:

In this prospective study, adult patients received standardized follow-up care after negative FCs including a reintroduction scheme and supportive telephone consultations. Data were collected by telephone interview (2 weeks after FC) and questionnaires (at baseline and 6 months after FC(s)): food habits questionnaire, State-Trait Anxiety Inventory, Food Allergy Quality of Life Questionnaire-Adult Form and Food Allergy Independent Measure. Frequency and reasons of reintroduction failure were analysed using descriptive statistics and risk factors with univariate analyses.

RESULTS:

Eighty patients were included with, in total, 113 negative FCs. Reintroduction failed on short-term (2 weeks after FC) in 20% (95% CI: 13%-28%). Common reasons were symptoms upon ingestion during the reintroduction scheme (50%) and no need to eat the food (23%). On the long-term (5-12 months after FC(s)), reintroduction failure increased to 40% (95% CI: 28%-53%). Common reasons were atypical symptoms after eating the food (59%) and fear for an allergic reaction (24%). Five risk factors for long-term reintroduction failure were found: if culprit food was not one of the 13 EU regulated allergens, reintroduction failure at short-term, atypical symptoms during FC, a lower quality of life and a higher state anxiety.

CONCLUSIONS AND CLINICAL RELEVANCE:

Reintroduction failure after negative FCs in adults is common, increases over time, and is primarily due to atypical symptoms. This stresses the need for more patient-tailored care before and after negative food challenges.

KEYWORDS:

food allergy; food challenge; reintroduction

PMID:
31955473
DOI:
10.1111/cea.13572

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center