Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Key clinical features to consider when diagnosing a food allergy in children include:
- Personal or family history of atopic diseases such as asthma, eczema, or allergic rhinitis, or known food allergies in parents or siblings.
- Details of foods avoided and reasons for avoidance.
- Assessment of presenting symptoms including the age at symptom onset, speed and reproducibility of symptoms after food exposure, severity, duration, frequency, and setting of reactions.
- Symptoms involving multiple organ systems, especially persistent symptoms.
- Signs and symptoms consistent with IgE-mediated allergy such as acute urticaria, angioedema (commonly lips, face, eyes), pruritus, erythema, oral pruritus, nausea, vomiting, abdominal pain, and respiratory symptoms like wheezing or shortness of breath.
- Signs and symptoms consistent with non-IgE-mediated allergy including atopic eczema, gastro-oesophageal reflux, loose stools, blood or mucus in stools, food refusal, constipation, perianal redness, pallor, tiredness, and faltering growth combined with gastrointestinal symptoms.
- Signs of anaphylaxis or systemic allergic reactions.
- Failure to respond to treatment for atopic eczema, gastro-oesophageal reflux disease, or chronic gastrointestinal symptoms.
- Physical examination findings such as growth parameters and signs of malnutrition or allergy-related comorbidities.
These features should be elicited through an allergy-focused clinical history and physical examination by a healthcare professional with appropriate competencies before considering allergy testing or referral to specialist care NICE CG116,NICE CKS,NICE CKS.