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, 13 (2), 100100
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The Effect of Age, Sex, Race/Ethnicity, Health Insurance, and Food Specific Serum Immunoglobulin E on Outcomes of Oral Food Challenges

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The Effect of Age, Sex, Race/Ethnicity, Health Insurance, and Food Specific Serum Immunoglobulin E on Outcomes of Oral Food Challenges

Andrew T Dang et al. World Allergy Organ J.

Abstract

Background: Although oral food challenge (OFC) is an important clinical procedure for diagnosing food allergy, there is a paucity of literature on the outcome of the procedure and specifically the patients on whom the procedure is performed from the aspects of their age, sex, race/ethnicity, health insurance status, and serum specific IgE to the food tested.

Objective: We aimed to review results of OFC and determine the impact of patient age, sex, race/ethnicity, insurance status, private or public, and food specific serum IgE on the outcome of OFC.

Methods: A retrospective chart review was performed of patients undergoing OFCs at a children's hospital outpatient allergy clinic over a two-year period. The outcome of OFC was allergic or non-allergic based on determination and documentation by the treating physician. A logistic regression model was built to determine the association between the OFC outcomes, age, and symptoms at the time of OFC. A Chi-square analysis was performed to check for any significant relationship between the OFC outcome and age when stratified by insurance status.

Results: Five hundred and eight children underwent 641 OFCs. Twenty nine percent of OFCs had an allergic outcome with the most commonly challenged foods being peanuts, eggs, and milk. Patient age and gender, when stratified by insurance status, did not have a significant effect on OFC outcomes. Serum IgE to peanuts and egg was significantly different between allergic OFC and non-allergic outcome. Vomiting and urticaria/angioedema correlated with an allergic OFC outcome.

Conclusion: OFCs confirm the food allergy diagnosis in about one-third of patients tested, and they should continue to be used when possible for an accurate diagnosis. Age, sex, and insurance status do not have a significant association with the outcome of OFC and cannot be added as predictive factors.

Conflict of interest statement

I, Andrew Dang, do not have any conflicts of interest to disclose. I, Pavan Chundi, do not have any conflicts of interest to disclose. I, Nadeem Mousa, do not have any conflict of interest to disclose. I, Amanda Beyer, do not have any conflicts of interest to disclose. I, Somboon Chansakulporn, do not have any conflicts of interest to disclose. I, Carina Venter, have received honorariums from Danone, Mead Johnson and Abbott. None constitute a conflict of interest. I, Tesfaye B. Mersha, do not have any conflicts of interest to disclose. I, Amal Assa'ad, have received research grants to my institution associated with Aimmune Therapeutics, DBV Technologies, Astellas, Sanofi and ABBVIE and the National Institute of Health, USA. I have a patent. I have no other financial affiliations. None constitute a conflict of interest.

Figures

Fig. 1
Fig. 1
Map of zip codes of patients who had OFCs divided by insurance type: Medicaid and non-Medicaid
Fig. 2
Fig. 2
Outcome of food challenges as non-allergic by age, sex and insurance type as Medicaid or non-Medicaid

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