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Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-Sponsored Expert Panel Report

Boyce, Joshua A., Assa'a, Amal, Burks, A. Wesley, Jones, Stacie M., Sampson, Hugh A., Wood, Robert A., Plaut, Marshall, Cooper, Susan F., Fenton, Matthew J., Arshad, Syed H., Bahna, Sami L., Beck, Lisa A., Byrd-Bredbenner, Carol, Camargo, Carlos A., Eichenfield, Lawrence, Furuta, Glenn T., Hanifin, Jon M., Jones, Carol, Kraft, Monica, Levy, Bruce D., Lieberman, Phil, Luccioli, Stefano, McCall, Kathleen M., Schneider, Lynda C., Simon, Ronald A., Simons, F Estelle R., Teach, Stephen J., Yawn, Barbara P. and Schwaninger, Julie M. NIAID-sponsored Expert Panel (2011) Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-Sponsored Expert Panel Report Nutrition, 27, (2), pp. 253-267. (PMID:21215925).

Record type: Article


Article Outline
1. Introduction

1.1. Overview
1.2. Relationship of the US Guidelines to other guidelines
1.3. How the Guidelines were developed

1.3.1. The Coordinating Committee
1.3.2. The Expert Panel
1.3.3. The independent, systematic literature review and report
1.3.4. Assessing the quality of the body of evidence
1.3.5. Preparation of the draft Guidelines and Expert Panel deliberations
1.3.6. Public comment period and draft Guidelines revision
1.4. Defining the strength of each clinical guideline
1.5. Summary
2. Definitions, prevalence, and epidemiology of food allergy

2.1. Definitions

2.1.1. Definitions of food allergy, food, and food allergens
2.1.2. Definitions of related terms
2.1.3. Definitions of specific food-induced allergic conditions
2.2. Prevalence and epidemiology of food allergy

2.2.1. Systematic reviews of the prevalence of food allergy
2.2.2. Prevalence of allergy to specific foods, foodinduced anaphylaxis, and food allergy with comorbid conditions
3. Natural history of food allergy and associated disorders

3.1. Natural history of food allergy in children
3.2. Natural history of levels of allergen-specific IgE to foods in children
3.3. Natural history of food allergy in adults
3.4. Natural history of conditions that coexist with food allergy

3.4.1. Asthma
3.4.2. Atopic dermatitis
3.4.3. Eosinophilic esophagitis
3.4.4. Exercise-induced anaphylaxis
3.5. Risk factors for the development of food allergy
3.6. Risk factors for severity of allergic reactions to foods
3.7. Incidence, prevalence, and consequences of unintentional exposure to food allergens
4. Diagnosis of food allergy

4.1. When should food allergy be suspected?
4.2. Diagnosis of IgE-mediated food allergy

4.2.1. Medical history and physical examination
4.2.2. Methods to identify the causative food Skin prick test Intradermal tests Total serum IgE Allergen-specific serum IgE Atopy patch test Use of skin prick tests, sIgE tests, and atopy patch tests in combination Food elimination diets Oral food challenges Nonstandardized and unproven procedures
4.3. Diagnosis of non-IgE-mediated immunologic adverse reactions to food

4.3.1. Eosinophilic gastrointestinal diseases
4.3.2. Food protein-induced enterocolitis syndrome
4.3.3. Food protein-induced allergic proctocolitis
4.3.4. Food protein-induced enteropathy syndrome
4.3.5. Allergic contact dermatitis
4.3.6. Systemic contact dermatitis
4.4. Diagnosis of IgE-mediated contact urticaria
5. Management of nonacute allergic reactions and prevention of food allergy

5.1. Management of individuals with food allergy

5.1.1. Dietary avoidance of specific allergens in IgEmediated food allergy
5.1.2. Dietary avoidance of specific allergens in non-IgE-mediated food allergy
5.1.3. Effects of dietary avoidance on associated and comorbid conditions, such as atopic dermatitis, asthma, and eosinophilic esophagitis
5.1.4. Food avoidance and nutritional status
5.1.5. Food labeling in food allergy management
5.1.6. When to re-evaluate patients with food allergy
5.1.7. Pharmacologic intervention for the prevention of food-induced allergic reactions IgE-mediated reactions Non-IgE-mediated reactions
5.1.8. Pharmacologic intervention for the treatment of food-induced allergic reactions
5.1.9. Immunotherapy for food allergy management Allergen-specific immunotherapy Immunotherapy with cross-reactive allergens
5.1.10. Quality-of-life issues associated with food allergy
5.1.11. Vaccinations in patients with egg allergy Measles, mumps, rubella, and varicella vaccine Influenza vaccine Yellow fever vaccine Rabies vaccines
5.2. Management of individuals at risk for food allergy

5.2.1. Nonfood allergen avoidance in at-risk patients
5.2.2. Dietary avoidance of foods with crossreactivities in at-risk patients
5.2.3. Testing of allergenic foods in patients at high risk prior to introduction
5.2.4. Testing in infants and children with persistent atopic dermatitis
5.3. Prevention of food allergy

5.3.1. Maternal diet during pregnancy and lactation
5.3.2. Breast-feeding
5.3.3. Special diets in infants and young children Soy infant formula versus cow’s milk formula Hydrolyzed infant formulas versus cow’s milk formula or breast-feeding
5.3.4. Timing of introduction of allergenic foods to infants
6. Diagnosis and management of food-induced anaphylaxis and other acute allergic reactions to foods

6.1. Definition of anaphylaxis
6.2. Diagnosis of acute, life-threatening, foodinduced allergic reactions
6.3. Treatment of acute, life-threatening, foodinduced allergic reactions

6.3.1. First-line and adjuvant treatment for foodinduced anaphylaxis
6.3.2. Treatment of refractory anaphylaxis
6.3.3. Possible risks of acute therapy for anaphylaxis
6.3.4. Treatment to prevent biphasic or protracted foodinduced allergic reactions
6.3.5. Management of milder, acute food-induced allergic reactions in health care settings
6.4. Management of food-induced anaphylaxis
Appendix A. Primary author affiliations and acknowledgments
Appendix B. List of abbreviations

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Published date: 6 January 2011
Organisations: Clinical & Experimental Sciences


Local EPrints ID: 197187
ISSN: 0899-9007
PURE UUID: d9d72983-b040-4823-85e5-2c2dfc5051d9

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Date deposited: 19 Sep 2011 15:23
Last modified: 18 Jul 2017 11:21

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Author: Joshua A. Boyce
Author: Amal Assa'a
Author: A. Wesley Burks
Author: Stacie M. Jones
Author: Hugh A. Sampson
Author: Robert A. Wood
Author: Marshall Plaut
Author: Susan F. Cooper
Author: Matthew J. Fenton
Author: Syed H. Arshad
Author: Sami L. Bahna
Author: Lisa A. Beck
Author: Carol Byrd-Bredbenner
Author: Carlos A. Camargo
Author: Lawrence Eichenfield
Author: Glenn T. Furuta
Author: Jon M. Hanifin
Author: Carol Jones
Author: Monica Kraft
Author: Bruce D. Levy
Author: Phil Lieberman
Author: Stefano Luccioli
Author: Kathleen M. McCall
Author: Lynda C. Schneider
Author: Ronald A. Simon
Author: F Estelle R. Simons
Author: Stephen J. Teach
Author: Barbara P. Yawn
Author: Julie M. Schwaninger

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