Clinical features in food allergy

The clinical features and distribution of allergens in food allergy in children and adults are defined in the light of a prospective study of 703 cases of food allergy validaded by challenge tests. These cases were recruited by the Departments of Medicine in Nancy and Paediatric Medicine in Toulouse. Food allergy appears before the age of 15 years in three quarters of cases. Atopic dermatitis represents the main manifestation of food allergy in children (50.5 % of paediatric cases). The clinical manifestations change deteriorate with age. Anaphylaxis represents one quarter of cases of food allergy in adults, versus 4.9 % in children. The oral syndrome is a much more frequent symptom in adults than in children. The distribution of food allergens also differs between these two populations. Five allergens are responsible for 78.1 % of food allergies in children: eggs (35.7 %), peanuts (23.6 %), cow's mirk (8.3 %), mustard (6 %) and fish (4.3 %). The distribution of allergens in adults reflects combinations of food and pollenic allergies, the importance of foods cross-reacting with latex and the fixed nature of certain food allergies. The diagnosis, often difficult, must be based on standardized investigations, mainly challenge tests.