Diagnosis of food allergy in Finland: Survey of pediatric practices

Food-related symptoms are common in the first years of life, and food aller gy should be diagnosed using an elimination challenge test. We surveyed Fin nish hospital-based pediatricians using a self-completion questionnaire to ascertain the current clinical practice: 24 of the 25 pediatricians (repres enting 24 of 25 hospitals) so approached gave evaluable responses. Food all ergies were diagnosed using a clinical elimination challenge test in patien ts with suspected allergy to cow's milk or cereals (wheat, rye, barley, oat s). Of the 24 departments, four reported that they performed challenge in a ll patients before diagnosis was confirmed, and 14 performed challenge in m ost patients before diagnosis was confirmed. The duration of the challenge varied from 0.5 to 7 days (median 4 days). A 1-week challenge was used in e ight hospitals. The double-blind placebo-controlled challenge was used in s even of the hospitals, and in none routinely. Altogether, 16 of the respond ents agreed that there is a need to establish clinical guidelines for the d iagnosis of food allergy. In conclusion, despite a long tradition of medica l education on the subject of food allergy, practices vary for its diagnosi s. There is therefore a requirement for appropriate clinical guidelines.