Unproven diagnostic procedures in IgE‐mediated allergic diseases

Niggemann, B.; Grüber, Christoph

doi:10.1111/j.1398-9995.2004.00495.x

Cited by 57 publications

(31 citation statements)

References 41 publications

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“…In vivo and in vitro tests are unreliable, and diagnosis is consequently based on oral provocation [27,28,29]. For these reasons, there has been a gradual falling away of medical interest in HFA as a cause of urticaria, counterbalancing increasing public awareness [36,37,38]. …”

Section: Discussionmentioning

confidence: 99%

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Lorenzo

Pacor

Mansueto

et al. 2005

Int Arch Allergy Immunol

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Background: Recurrent chronic idiopathic urticaria (RCIU) is a common skin condition that affects 0.1–3% of the population in the USA and Europe and accounts for nearly 75% of all ‘ordinary’ chronic urticaria (CU) cases. Methods: We studied 838 consecutive patients with RCIU referred to hospital between 1998 and 2003. Patients with known causes of CU were excluded. Clinical history, physical examination, and symptom diaries were evaluated during two periods, a diet-free period (1 week) and a food-additive-free diet (FAFD) period (4 weeks), respectively, and two double-blind placebo-controlled (DBPC) challenges of six food additives were administered. The first DBPC challenge included a mixture of the six food additives (DBPC_mixed) given to all patients. The second DBPC challenge comprised the single food additives, administered at increasing doses (DBPC_single) to patients with a positive DBPC_mixed test and 105 patients with a negative DBPC_mixed test, as a control. Results: The DBPC_mixed challenge was positive in 116 patients. None of the 105 control patients had a positive DBPC_single test. Only 31 DBPC_single tests were positive in patients with positive DBPC_mixed challenge. Twenty-four of the 116 patients showing a positive DBPC_mixed challenge also had a positive DBPC_single result. Conclusions: Our results confirmed that food additive hypersensitivity reactions occurred in few RCIU patients using DBPC_single challenge. The combination of the results of FAFD and DBPC_mixed challenge seems to be of considerable practical interest for allergists, internists and dermatologists, rather than the data of clinical history and the results of DBPC_single challenge, in patients with RCIU.

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Section: Discussionmentioning

confidence: 99%

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Lorenzo

Pacor

Mansueto

et al. 2005

Int Arch Allergy Immunol

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“…There are numerous complementary/alternative diagnostic techniques available (table 4), often not based on experimental proof of concept [77]. These alternative techniques are largely used in the field of "food allergy/intolerance".…”

Section: Complementary/alternative Diagnostic Proceduresmentioning

confidence: 99%

Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases

Passalacqua

Compalati

Schiappoli³

et al. 2005

Monaldi Arch Chest Dis

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The use of Complementary/Alternative Medicines (CAM) is largely diffused and constantly increasing, especially in the field of allergic diseases and asthma. Homeopathy, acupuncture and phytotherapy are the most frequently utilised treatments, whereas complementary diagnostic techniques are mainly used in the field of food allergy- intolerance. Looking at the literature, the majority of clinical trials with CAMS are of low methodological quality, thus difficult to interpret. There are very few studies performed in a rigorously controlled fashion, and those studies provided inconclusive results. In asthma, none of the CAM have thus far been proved more effective than placebo or equally effective as standard treatments. Some herbal products, containing active principles, have displayed some clinical effect, but the herbal remedies are usually not standardised and not quantified, thus carry the risk of toxic effects or interactions. None of the alternative diagnostic techniques (electrodermal testing, kinesiology, leukocytotoxic test, iridology, hair analysis) have been proved able to distinguish between healthy and allergic subjects or to diagnose sensitizations. Therefore these tests must not be used, since they can lead to delayed or incorrect diagnosis and therapy.

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“…Of particular concern are restrictive elimination diets without appropriate counseling, and in children those based on complementary diagnostic allergy testing are of unproven diagnostic value [3]. Food allergy is often misconceived.…”

Section: Introductionmentioning

confidence: 99%

Allergen Avoidance Approaches in Food Allergy Management

Koletzko¹,

Koletzko²

2009

Microbial Host-Interaction: Tolerance Versus Allergy

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Dietary elimination of causative food ingredients, usually food proteins, is the basis of treating food hypersensitivity. Proper diagnostic assessment is essential to avoid burdening children with unnecessary dietary restrictions with potential adverse effects. Diagnosis requires a detailed history, allergen elimination, and re-challenge with suspected foods. Complete elimination of causative food components depends on professional counseling and training of the patient and family, and transparent labeling of food products. Elimination diets carry the risk of inducing insufficient supplies of critical nutrients with adverse effects on health and wellbeing, particularly in children with exclusion of foods that provide a major part of dietary supply and patients with multiple food allergies. Infants and young children with cow's milk allergy, who have not been fully breastfed, require milk substitutes based on extensively hydrolyzed protein or amino acids. Elimination diets must be supervised and monitored to a similar degree as drug treatments, and the need for continued dietary elimination should be reviewed on a regular basis and re-challenges considered.

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Unproven diagnostic procedures in IgE‐mediated allergic diseases

Cited by 57 publications

References 41 publications

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Food-Additive-Induced Urticaria: A Survey of 838 Patients with Recurrent Chronic Idiopathic Urticaria

Complementary and alternative medicine for the treatment and diagnosis of asthma and allergic diseases

Allergen Avoidance Approaches in Food Allergy Management

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