Food Allergy Sensitization and Presentation in Siblings of Food Allergic Children

J Allergy Clin Immunol Pract. 2016 Sep-Oct;4(5):956-62. doi: 10.1016/j.jaip.2016.04.009. Epub 2016 Jul 12.


Background: Many parents of food allergic children have concerns about the development of food allergies in their other children.

Objective: We sought to determine prevalence of food sensitization and clinical food allergy among siblings of food allergic children.

Methods: Two thousand eight hundred and thirty-four children were enrolled in the Chicago Family Cohort Food Allergy study. One thousand one hundred and twenty children (ages 0-21 years) with a food allergy (defined by a reported reaction history and evidence of food-specific IgE or skin prick test) and at least 1 biological sibling were included in this study.

Results: Among siblings of children with food allergy, 33.4% had no sensitization and no clinical symptoms to food. Fifty-three percent had a positive food serum-specific IgE or skin prick test, but no reported symptoms of food allergy. Only 13.6% of siblings were both sensitized and clinically reactive to the same food. Milk allergy was the most common allergy among siblings (5.9%), followed by egg allergy (4.4%) and peanut allergy (3.7%).

Conclusions: In a large cohort of food allergic families, only a small proportion of siblings were both sensitized and clinically reactive to a food. Sensitization without reactivity was common among siblings. Testing for food allergy in siblings without a history of clinical reactivity appears to be unjustified. Screening may lead to negative consequences related to potential misdiagnosis and unnecessary avoidance of a food. More data are needed to determine the absolute risk of food allergy development in siblings of food allergic children.

Keywords: Childhood food allergy; ImmunoCAP; Milk allergy; Peanut allergy; Risk; Sensitization; Siblings; Skin testing.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Allergens / immunology
  • Child
  • Child, Preschool
  • Female
  • Food / adverse effects
  • Food Hypersensitivity / blood
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / epidemiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Siblings*
  • Skin Tests
  • Young Adult


  • Allergens