Food allergy in children: focus on IgE-mediated food allergy

Abstract

Food allergy (FA) has become more common in recent decades, and it is a serious health problem in children. FA is divided into immunoglobulin E (IgE)-mediated and non-IgE-mediated FA based on its mechanism. FA most often develops early in life, affecting up to 10% of children, and increasing concerns have been raised regarding severe FA including food-induced anaphylaxis, especially in young children. The 2 most common food allergens worldwide are milk and eggs, while the third most common allergen varies among countries. In addition to a detailed and convincing history of diverse symptoms (involving the skin, gastrointestinal, respiratory, cardiovascular, and neurologic systems) after exposure to culprit foods, the following tools can be useful in the diagnosis of FA: the skin prick test, measurement of serum food-specific IgE antibodies, and the elimination or provocation test with suspected foods. The current recommended management of FA relies on the strict avoidance of causative foods; the immediate treatment of allergic reactions, including epinephrine use for food-induced anaphylaxis: and education to prevent further reactions. Emerging approaches for tolerance induction to FA, such as food immunotherapy, have been investigated, but concrete evidence for clinical application is lacking. This review presents a detailed overview of the pathogenesis of FA, its prevalence, common culprit foods, and its diagnosis and management, and additionally shares recent data on common causative foods in Korean infants and children.