Evaluation of the results of oral food challenges conducted in specialized and general hospitals

Abstract

BackgroundOral food challenge (OFC) tests are conducted in both specialized institutions and general hospitals. We aimed to compare the severity of the conditions of the patients between these 2 types of institutions in order to consider the role of such institutions in society.ObjectiveWe evaluated the results of OFC tests for hen's egg, cow's milk, and wheat that were conducted in a specialized institution (Aichi Children's Health and Medical Center [ACHMC], n = 835) and in 4 general hospitals (n = 327) in Aichi prefecture, Japan.MethodsThe symptoms provoked were scored using the total score (TS) of the Anaphylaxis Scoring Aichi scoring system in combination with the total ingested protein dose (Pro) before the appearance of allergic symptoms.ResultsThe total ingested dose of the challenge-positive patients in ACHMC was significantly less than that in the general hospitals (p < 0.01). The median TS of the provoked symptoms in ACHMC and the general hospitals did not differ to a statistically significant extent in the hen's egg or cow's milk challenges; however, the median TS in ACHMC was significantly lower than that in the general hospitals for the wheat challenge (p = 0.02). The median TS/Pro values in ACHMC were almost identical to the upper 25% of the TS/Pro values in the general hospitals, suggesting that the specialized institution usually managed more severe patients.ConclusionThe specialized institution performed OFC tests at a lower threshold dose, but provoked similar TSs to the general hospitals. This evaluation may help in optimizing the distribution of patients to general hospitals and specialized institutions.

Safety of Oral Food Challenge for Individuals with Low Egg White and Ovomucoid-Specific IgE Antibodies

“…As the two participating institutions conduct most of the OFCs in the Kumamoto Prefecture, these study results are likely to indicate the current status of the individuals with HE FAs living in the local area. Most data regarding children with FAs in Japan are reported by large allergy care centers in urban areas [9‒12]. Therefore, our data indicate that OFC tests are already becoming part of the routine diagnostic procedure for FAs in Japan, even at local secondary care facilities [13].…”

Assessment of egg and milk allergies among Indians by revalidating a food allergy predictive model

“…However, the rate of both egg and milk positive OFC was lower than open challenges reported from Japan (61% and 72% respectively). 29 A possible reason for this relatively low rate of positive food challenge in our study might be the inclusion criteria of a clinical history of convincing egg or milk allergy. A positive SPT or specific IgE was not always co-related.…”

Exercise‐induced allergic reactions on desensitization to wheat after rush oral immunotherapy

“…An increasing dose (0.2‐0.5‐1‐2‐5 g) of boiled udon noodles was given every 30 minutes until the objective allergic symptoms were observed. The severity of symptoms was scored using the Anaphylaxis Scoring Aichi (ASCA), a scoring system developed in our department (Figure ) . In the ASCA system, the total score (TS; maximum 240 points) is defined as the sum of the 5 organ scores (1 to 60 points) observed throughout a course of OFCs.…”

“…The severity of symptoms was scored using the Anaphylaxis Scoring Aichi (ASCA), a scoring system developed in our department ( Figure S1). [24][25][26][27] In the ASCA system, the total score (TS; maximum 240 points) is defined as the sum of the 5 organ scores (1 to 60 points) observed throughout a course of OFCs. To express the overall result of the OFC, TS/Pro (points/g) was defined by dividing the TS by the cumulative protein dose of the allergen (Pro).…”