Food allergy: which tests are worth doing and which are not?

Ann Clin Biochem. 2011 Jul;48(Pt 4):300-9. doi: 10.1258/acb.2011.011011. Epub 2011 Apr 27.


Adverse reactions to foods may arise by a variety of mechanisms, both immune (IgE and non-IgE) and non-immune mediated. This article considers those assays useful in the diagnosis of Type 1 hypersensitivity to foods (IgE-based) and, importantly, discusses those assays where evidence is lacking for their use. In all cases of suspected food allergy, a full clinical history is indispensable in facilitating diagnosis. Total serum IgE is not a suitable screen for food allergy. Suspect allergens may be confirmed by either skin prick testing or serological assays for specific IgE. Several studies suggest concentrations of food-specific IgE at which there is a high probability of reaction on food challenge. These cut-off levels are now being used by physicians to direct clinical advice. However, it is important to note that not all studies agree on these limits and the chosen cut-off is dependent on the population studied and the assay used.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Allergens*
  • Antibody Specificity
  • Child
  • Child, Preschool
  • Egg Hypersensitivity / diagnosis
  • Egg Hypersensitivity / epidemiology
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / epidemiology
  • Humans
  • Hypersensitivity, Immediate / diagnosis*
  • Hypersensitivity, Immediate / epidemiology
  • Immunoassay
  • Immunoglobulin E / blood*
  • Milk Hypersensitivity / diagnosis
  • Milk Hypersensitivity / epidemiology
  • Peanut Hypersensitivity / diagnosis
  • Peanut Hypersensitivity / epidemiology
  • Skin Tests
  • United Kingdom / epidemiology


  • Allergens
  • Immunoglobulin E