Hidden and Rare Food Allergens in Pediatric Age

Abstract

In food allergy management, the avoidance of the allergen that caused the reaction plays a fundamental role. Nevertheless, that can be thwarted in case of accidental exposure to a rare or hidden allergen, causing the adoption of a monotonous diet and a consequent reduction in the quality of life of the patient and their family. The identification of a rare and hidden allergen is an important diagnostic challenge, taking into account that a significant proportion of all food reactions is in reality due to them. The aim of the present review is to provide the pediatric allergist an overview of the possible sources of rare and hidden food allergens, taking into consideration the routes of exposure to these potential allergens with the main examples published in the scientific literature and the distinction between types of direct or cross-contamination. The identification of the allergen responsible for the reaction and the provision of a dietary advice customized for the specific individual’s dietary habits is essential to improve quality of life of the familiar nucleus and to reduce the risk of further allergic reactions.

New insights in hidden food allergies

“…Information on the circumstances at the time of the reaction may reveal the involvement of cofactors. 45 , 46 An interested allergist and a cooperative patient are needed to suspect a hidden food allergen, in planning to identify the culprit, and the provision of personalized dietary management. Skin-prick testing with the suspected food as a whole and its individual ingredients might be rewarding but of very low reliability for hot spices or synthetic additives.…”

O impacto psicossocial e emocional das alergias alimentares em crianças

“…A literatura científica destaca a importância de evitar o alérgeno causador como um pilar fundamental no manejo clínico da alergia alimentar. No entanto, mesmo quando a prevenção é realizada com meticulosidade, não se pode ignorar a possibilidade de exposições acidentais, que podem resultar em sintomas agudos de anafilaxia (TOMEI L, et al, 2023). Diante desse cenário, situações de exposição involuntária frequentemente exigem ajustes incontornáveis na rotina cotidiana, podendo até mesmo impor limitações ou restrições na participação em atividades sociais.…”