Roberts, Graham (2017) Food challenges, the risks and benefits. Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 47 (9), 1106-1107. (doi:10.1111/cea.12999).
Abstract
There have been reports of a 3‐year‐old boy who died during a baked milk challenge in the United States. A real tragedy for all, particularly his family. The American Academy of Allergy, Asthma & Immunology, the American College of Allergy, Asthma & Immunology and the Canadian Society of Allergy and Clinical Immunology have rapidly released a statement.1 While we do not know the full details surrounding this case, perhaps it is time to look at the balance between the risks and benefits for food challenges. Although this is the first reported fatality associated with a food challenge, all experienced allergists will be aware that severe reactions can occur with these procedures.2 The likelihood of severe reactions depends on the indication for challenge. The risk is low where the question is: has a patient outgrown their food allergy? But it is high when it is a so called demonstration challenge—when a challenge is occasionally undertaken to convince an uncertain patient that they have a food allergy when they have not had a reaction for many years but have diagnostic results to suggest clinical allergy. There is a surprising lack of safety data reported from routine food challenges, but research studies would suggest that they are safe, albeit there is a possibility of severe reactions
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