Cover: Prevalence, Natural History, Diagnosis, and Treatment of Food Allergy

Prevalence, Natural History, Diagnosis, and Treatment of Food Allergy

A Systematic Review of the Evidence

by Jennifer J. Schneider Chafen, Sydne Newberry, Marc Riedl, Dena M. Bravata, Margaret A. Maglione, Marika Booth, Vandana Sundaram, Neil M. Paige, Ali Towfigh, Benjamin J. Hulley, Paul G. Shekelle

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Abstract

Food allergies have significant deleterious effects on family economics, social interactions, school and work attendance, and health-related quality of life. However, currently licensed treatments target only the symptoms of reactions and anaphylaxis, not the allergies themselves. Food allergies are heterogeneous in terms of both their underlying pathophysiology (eg, mediated via both IgE and non-IgE immunologic pathways) and their clinic manifestations (ranging from mild rashes to life-threatening anaphylaxis). The literature on food allergies lacks a clear consensus regarding the most effective diagnostic and management approaches to even the most common conditions. Under contract from the National Institute of Allergy and Infectious Diseases (NIAID) and in support of ongoing work to produce clinical practice guidelines, the authors reviewed the available evidence on the prevalence, diagnosis, management, and prevention of food allergies. This review presents their findings for the most common allergenic foods: cow's milk, hen's egg, peanut or tree nut, and shellfish or fish, which account for more than 50% of all allergies to food.

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