Diagnosis and assessment of food allergy in children and young people: summary of NICE guidance

Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 2% of adults in westernised countries, and their prevalence seems to be rising, as does the prevalence of all allergic diseases. 1 Correct diagnosis of food allergy in children and young people is essential to reduce the incidence of adverse reactions that result from true food allergies that are missed, and to reduce cases of unnecessary treatment after an incorrect diagnosis. [Based on low quality evidence from diagnostic and observational studies and the experience and opinion of the GDG] IgE mediated Non-IgE mediated Skin Pruritus Pruritus Erythema Erythema Acute urticaria (localised or generalised) Atopic eczema Acute angio-oedema-most commonly lips, face, and around eyes Gastrointestinal system Angio-oedema of the lips, tongue, and palate Gastro-oesophageal reflux disease Oral pruritus Loose or frequent stools Nausea Blood and/or mucus in the stools Colicky abdominal pain Abdominal pain Vomiting Infantile colic Diarrhoea Food refusal or aversion Constipation Perianal redness Pallor and tiredness Faltering growth and one or more of the gastrointestinal symptoms above (with or without serious atopic eczema) Respiratory system (in combination with one or more of the above symptoms) Upper respiratory tract symptoms (nasal itching, sneezing, rhinorrhoea, or congestion (with or without conjunctivitis) Lower respiratory tract symptoms (cough, chest tightness, wheezing, or shortness of breath) Other Signs or symptoms of anaphylaxis or other systemic reactions *This list is not exhaustive. [Based on low quality evidence from diagnostic and observational studies and on the experience...