LABIAL FOOD CHALLENGE IN CHILDREN WITH FOOD ALLERGY

The current increase in the prevalence of food allergies appears to ha ve several causes including better screening, improved diagnosis and c hanges in both the techniques used by food manufacturers and eating ha bits. Labial food challenge (LFC)is simple, rapid to perform and is as sociated with only low risks of systemic reaction. It is thus an appea ling alternative to the oral food challenge (OFC) for pediatric use. W e report a series of 202 LFC performed over two years in 142 children with food allergy suspected from the case history, positive skin prick test and specific serum IgE assays: 156 LFC were positive; and 46 neg ative, followed by positive single-blind, placebo-controlled food chal lenges (SB-PCFC). The foods provoking reactions were egg white (75 cas es), peanut (60 cases), mustard (23 cases), cow's mill; (13 cases), co d (8 cases), kiwi fruit, shrimp (4 cases each), chicken, peanut oil (3 cases each), hazel nuts (2 cases), and snails, apple, fennel, garlic, chilli peppers, pepper, and duck (1 case each). LFC positivity was mo stly (89.7% of cases) manifested as a labial edema with contiguous urt icaria. There were systemic reactions in 4.5% of cases: generalized ur ticaria, hoarseness and rapid-onset and generalized eczema. The 46 inf ants with negative LFC results had positive SB-PCFC. The reactions wer e in 34 cases generalized urticaria, 10 cases asthma attacks, 2 cases early and generalized eczema, and in one case general anaphylactic sho ck. The sensitivity of the LFC was 77%. The LFC was easy to perform wi th children. Positive results indicate the presence of food allergy, b ut negative results require further investigations preferably double-b lind, placebo-controlled food challenge (DBPCFC).