Food allergy may be under-diagnosed among American children

A large percentage of cases of food allergy among children never receive a formal physician diagnosis, suggesting that the condition is under-diagnosed, according to researchers at Children’s Memorial Hospital in Chicago and several other institutions.

Among 40,104 children whose data were examined using a randomized, cross-sectional survey administered in American households, 3449 cases of food allergy were identified. Among children with food allergy, 65.9% received a formal physician diagnosis. Only 20.2% of those children with a formal diagnosis received an oral food challenge, the diagnostic gold standard.

According to the researchers, children with severe symptoms such as anaphylaxis, wheezing, trouble breathing, and low blood pressure were more frequently formally diagnosed; these diagnoses were more often confirmed by oral food challenge. Children with a milk or peanut allergy had higher odds of being formally diagnosed (odds ratio [OR] 2.1 and 1.5, respectively), while children with a fish or shellfish allergy had lower odds (OR 0.3 and 0.6, respectively).