title: A review of oral food challenges in children presenting to a single tertiary centre with perceived or true food allergies.
abstract: BACKGROUND
  The prevalence of perceived food allergies exceeds that of true food allergies. Unnecessary food avoidance may increase parental and patient anxiety, reduce quality of life and increase the risk of nutritional deficiency. An oral food challenge (OFC) can provide an objective measure regarding the presence or absence of food allergies in a child. This study reviews the indications for and outcomes of OFCs performed on children.
  
  
  METHODS
  A retrospective review was performed on all children who underwent OFCs at the Allergy Unit of the National University Hospital, Singapore, over a three-year period.
  
  
  RESULTS
  A total of 197 OFCs were performed among 58 patients (34 male, 24 female). Most of the tests were for allergies to tree nuts (n = 107). Among the OFCs, 43.1% were for foods that were avoided and never eaten due to perceived food allergies, 25.9% were for foods that had previously resulted in positive skin prick tests (SPTs) and/or immunoassay results, 16.2% were for foods thought to worsen eczema and 14.7% were for foods thought to have caused a previous reaction. Of all the OFCs, 5% were positive, although adverse reactions were mostly cutaneous. Challenge-positive patients had either positive SPTs (wheal > 3 mm) or raised serum immunoglobulin E levels to specific foods that they reacted to during the challenges. No episodes of anaphylaxis were reported after the challenge. Most of the patients were able to safely introduce the avoided foods into their diets.
  
  
  CONCLUSIONS
  OFCs provide an objective assessment for suspected food allergies.
authors.affiliation: Department of Paediatrics, International Medical University Clinical School Seremban, Malaysia.
authors.forename: Meera
authors.initials: M
authors.lastname: Thalayasingam
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore ; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore.
authors.forename: Evelyn Xiu Ling
authors.initials: EX
authors.lastname: Loo
authors.affiliation: Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore.
authors.forename: Michelle Meiling
authors.initials: MM
authors.lastname: Tan
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore.
authors.forename: Hugo Van
authors.initials: HV
authors.lastname: Bever
authors.affiliation: Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore ; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore.
authors.forename: Lynette Pei-Chi
authors.initials: LP
authors.lastname: Shek
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005502:Food / Q000009:adverse effects*; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D012882:Skin Tests; D062606:Tertiary Care Centers; D013997:Time Factors
keywords: food allergy; indications; oral food challenges; outcomes; safety