Panel test for Food allergies
Skin testing (pin prick)
- Generally, less costly but not as easy to perform or as available as food-specific IgE testing
- Best used to confirm suspected allergens
- Lower specificity than IgE testing but high negative predictive value
- Does not predict severity of allergic reaction
- Positive results may not be diagnostic – cross-reactivity exists between proteins
Food-specific serum IgE testing
- Use in combination with patient history
- Panel allergen tests may be helpful (ImmunoCAP appears to be best validated) – tests most common allergens
- Does not predict severity of allergic reaction
- Positive results may not be diagnostic – cross-reactivity exists between proteins
Serum tryptase
- Elevated at 1-4 hours after anaphylactic reaction
- Can help confirm diagnosis
Oral food challenges
- Should be performed as double-blind, placebo-controlled challenge – must be done where resources are available to manage allergic reactions
- Food challenges may be helpful but should not precede IgE testing
- Administration of suspected food in gradually increasing doses
- May be necessary if pin prick or IgE testing is negative and strong suspicion still exists for allergy
- May be dangerous to do food testing in certain patients with severe allergies – should wait at least 2 years after a severe reaction to perform testing
Patch testing
- Not recommended by the National Institute of Allergy and Infectious Diseases for routine evaluation
- Typically used in non-IgE-mediated food allergy (eg, eosinophilic esophagitis)
- No standard reagent methods or interpretation available
IgG testing – not recommended
Allergens, Food, Common Adult Food IgE
Test for 11 most common food allergens and total serum IgE (clam, egg white, codfish/whitefish, corn, cow’s milk, peanut, shrimp, soybean, walnut, and wheat)
Allergens, Food, grain Profile
Components include Oat flour, Corn, sesame, rye, Wheat flour and Buckwheat flour
Allergens, Food, Common Panel IgG
Components include almond, banana, cow’s milk, chicken, corn, egg white, garlic, gluten, oat, orange, peanut, potato white, rice, soybean, tomato, wheat, whey, and baker’s yeast
Allergens, Food, Comprehensive Profile
Components include barley, beef, bell pepper, cabbage, carrot, chicken, codfish/whitefish, corn, crab, egg white, grape, lettuce, cow’s milk, navy bean, oat, orange, peanut, potato, rice, rye, shrimp, soybean, tomato, tuna, and wheat
Allergens, Food, Meat Panel IgG
Components include chicken, Lamb and beef
Allergens, Food, Nut Mix Profile
Components include almond, coconut, peanut, pecan, and sesame seed
Allergens, Food, Salad Profile
Components include celery, lettuce, orange, parsley, and tomato
Allergens, Food, Seafood Profile
Components include codfish/whitefish, shrimp, Blue mussel, Salmon and tuna
Allergens, Food, Citrus Profile
Components include Grapefruit, Lemon, Orange, and Mandarin
Allergens, Food, Vegetable Profile IgE
Components include carrot, corn, pea, potato, and lima/white bean
Allergens, Inhalants/Foods, Comprehensive Profile
Components include Alternaria alternata (tenuis), Aspergillus fumigatus, bent/redtop grass, Bermuda grass, cat epithelium & dander, cow hair & dander, dog dander, egg white, elm tree, false ragweed, feather mix, horse hair & dander, house dust greer, June grass/Kentucky bluegrass, cow’s milk, oak tree, olive tree, orchard grass/cocksfoot grass, peanut, Penicillium notatum, pigweed, Russian thistle, rye, sagebrush/wormwood, soybean, sycamore tree, timothy grass, western ragweed, and wheat
Allergens, Inhalants/Foods, Environmental Profile
Components include baker’s yeast, cat epithelium & dander, D. farinae (mites), D. pteronyssinus (mites), dog dander, egg white, egg yolk, feather mix, horse hair & dander, house dust, cow’s milk, orange, peanut, rice, shrimp, and soybean
Allergens, Pediatric Foods Profile
Components include egg white, cow’s milk, oat, soybean, and wheat
Allergens, Pediatric Foods/Inhalants Profile
Components include Alternaria alternata (tenuis), cat epithelium & dander, corn, D. farinae (mites), D. pteronyssinus (mites), dog dander, egg white, house dust greer, cow’s milk, soybean, and wheat
Chronic Enteric Hypersensitivity Reflexive Profile
Components include celiac disease dual antigen screen with reflex, codfish, egg white, gluten, hazelnut (filbert), cow’s milk, peanut, sesame seed, shrimp, soybean, walnut, and wheat
Reflex pattern – if celiac disease dual antigen screen is ≥20 units, then tTG IgA and gliadin peptide IgA will be added; if tTG IgA and gliadin peptide IgA are negative, tTG IgG and gliadin peptide IgG will be added
A-B
Allergen, Food, Almond
Allergen, Food, Almond IgG
Allergen, Food, Alpha-Gal (galactose-alpha-1,3-galactose) IgE
Allergen, Food, Alpha-Lactalbumin
Allergen, Food, Anchovy IgE
Allergen, Food, Annatto Seed IgE
Allergen, Food, Apple
Allergen, Food, Apricot
Allergen, Food, Asparagus IgE
Allergen, Food, Avocado
Allergen, Food, Avocado IgG
Allergen, Food, Anise
Allergen, Food, Baker’s Yeast IgG
Allergen, Food, Baker’s Yeast/Brewer’s Yeast
Allergen, Food, Banana
Allergen, Food, Banana IgG
Allergen, Food, Barley
Allergen, Food, Barley IgG
Allergen, Food, Basil IgE
Allergen, Food, Bass Black IgE
Allergen, Food, Bay Leaf IgE
Allergen, Food, Beef
Allergen, Food, Beef IgG
Allergen, Food, Beet Root IgE
Allergen, Food, Beta-Lactoglobulin
Allergen, Food, Black Bean IgE
Allergen, Food, Black Olive IgE
Allergen, Food, Black Pepper
Allergen, Food, Blackberry IgE
Allergen, Food, Blue Mussel
Allergen, Food, Blueberry
Allergen, Food, Brazil Nut
Allergen, Food, Broccoli
Allergen, Food, Broccoli IgG
Allergen, Food, Buckwheat IgE (Fagopyrum esculentum)
Allergen, Food, Black tiger shrimp
Allergen, Food, Cabbage
Allergen, Food, Carp
Allergen, Food, Canola (Rapeseed) Oil IgE
Allergen, Food, Caraway Seed IgE
Allergen, Food, Cardamom Seed IgE
Allergen, Food, Carob Gum/Locust Bean IgE
Allergen, Food, Carrot
Allergen, Food, Casein
Allergen, Food, Casein (Cow’s Milk) IgG
Allergen, Food, Cashew
Allergen, Food, Cashew IgG
Allergen, Food, Catfish IgE
Allergen, Food, Cauliflower IgE
Allergen, Food, Celery
Allergen, Food, Cheddar Cheese IgG
Allergen, Food, Cheese Mold
Allergen, Food, Cheese Mold IgG
Allergen, Food, Cheese, Cheddar
Allergen, Food, Cherry IgE
Allergen, Food, Chestnut
Allergen, Food, Chicken
Allergen, Food, Chicken IgG
Allergen, Food, Chickpea (Garbanzo Bean) IgE
Allergen, Food, Chocolate
Allergen, Food, Chocolate IgG
Allergen, Food, Cinnamon
Allergen, Food, Clam
Allergen, Food, Clam IgG
Allergen, Food, Clove IgE
Allergen, Food, Coconut
Allergen, Food, Coconut IgG
Allergen, Food, Codfish IgE
Allergen, Food, Coffee
Allergen, Food, Coffee IgG
Allergen, Food, Common Millet IgE
Allergen, Food, Coriander/Cilantro IgE
Allergen, Food, Corn
Allergen, Food, Corn IgG
Allergen, Food, Crab
Allergen, Food, Crab IgG
Allergen, Food, Cranberry IgE
Allergen, Food, Crayfish IgE
Allergen, Food, Cucumber IgE
Allergen, Food, Dill IgE
Allergen, Food, Cultivated rye
Allergen, Food, Common Mussel
E-K
Allergen, Food, Egg White
Allergen, Food, Egg Components IgE
Allergen, Food, Egg White IgG
Allergen, Food, Egg Whole
Allergen, Food, Egg Yolk
Allergen, Food, Egg Yolk IgG
Allergen, Food, Eggplant
Allergen, Food, Flaxseed/Linseed IgE
Allergen, Food, Garlic
Allergen, Food, Fig
Allergen, Food, Garlic IgG
Allergen, Food, Gelatin Bovine IgE
Allergen, Food, Gelatin Porcine IgE
Allergen, Food, Ginger IgE
Allergen, Food, Gluten
Allergen, Food, Gluten IgG
Allergen, Food, Goat Milk IgE
Allergen, Food, Grape
Allergen, Food, Grapefruit
Allergen, Food, Green Bean (String) IgE
Allergen, Food, Guar Gum IgE
Allergen, Food, Gulf Flounder IgE
Allergen, Food, Haddock IgE
Allergen, Food, Halibut
Allergen, Food, Hazelnut
Allergen, Food, Herring IgE
Allergen, Food, Honey IgE
Allergen, Food, Honeydew (Melon)
Allergen, Food, Hops
Allergen, Food, Kidney Bean
Allergen, Food, Kiwi
L-O
Allergen, Food, Lamb
Allergen, Food, Lemon
Allergen, Food, Lentil
Allergen, Food, Lettuce
Allergen, Food, Lettuce IgG
Allergen, Food, Lima Bean/White Bean
Allergen, Food, Lime IgE
Allergen, Food, Lobster
Allergen, Food, Lobster IgG
Allergen, Food, Macadamia Nut IgE
Allergen, Food, Mackerel
Allergen, Food, Mahi Mahi IgE
Allergen, Food, Malt
Allergen, Food, Malt IgG
Allergen, Food, Mandarin IgE
Allergen, Food, Lupine seed
Allergen, Food, Millet
Allergen, Food, litchi
Allergen, Food, Melon
Allergen, Food, Mango
Allergen, Food, Northern Prawn
Allergen, Food,Sheep’s Milk
Allergen, Food, Mare’s milk
Allergen, Food, Camel’s milk
Allergen, Food, Milk (Cow’s)
Allergen, Food, nBos d 8 Casein Milk
Allergen, Food, Milk (Cows) Components IgE
Allergen, Food, Mint IgE
Allergen, Food, white Mushroom
Allergen, Food, Mushroom IgG
Allergen, Food, Mustard
Allergen, Food, Meat horse
Allergen, Food, Navy Bean
Allergen, Food, Nectarine IgE
Allergen, Food, Nutmeg IgE
Allergen, Food, Oat
Allergen, Food, Oat IgG
Allergen, Food, Octopus IgE
Allergen, Food, Olives IgG
Allergen, Food, Onion
Allergen, Food, Onion IgG
Allergen, Food, Orange
Allergen, Food, Orange IgG
Allergen, Food, Oregano IgE
Allergen, Food, Orris Root IgE
Allergen, Food, Ovalbumin IgE
Allergen, Food, Ovomucoid IgE
Allergen, Food, Oyster
Allergen, Food, Oyster IgG
P-R
Allergen, Food, Papaya
Allergen, Food, Paprika
Allergen, Food, Parsley
Allergen, Food, Pea
Allergen, Food, Peanut
Allergen, Food, Peanut Components IgE
Allergen, Food, Peanut IgG
Allergen, Food, Pear
Allergen, Food, Pecan
Allergen, Food, Pepper
Allergen, Food, Pepper C. annuum IgE
Allergen, Food, Pepper C. frutescens IgE
Allergen, Food, Perch IgE
Allergen, Food, Pine (Pinon) Nut
Allergen, Food, Pineapple
Allergen, Food, Pineapple IgG
Allergen, Food, Pistachio
Allergen, Food, Plaice IgE
Allergen, Food, Plum
Allergen, Food, Poppy Seed IgE
Allergen, Food, Pork
Allergen, Food, Pork IgG
Allergen, Food, Potato
Allergen, Food, Meat Pig
Allergen, Food, Potato (White) IgG
Allergen, Food, Pumpkin IgE
Allergen, Food, Pumpkin Seed IgE
Allergen, Food, Quinoa IgE
Allergen, Food, Raspberry IgE
Allergen, Food, Red Dye/Carmine (Red 4) IgE
Allergen, Food, Red Snapper IgE
Allergen, Food, Rice
Allergen, Food, Rice IgG
Allergen, Food, Rye flour
Allergen, Food, Rye IgG
S-Z
Allergen, Food, Sage IgE
Allergen, Food, Salmon
Allergen, Food, Sardine IgE
Allergen, Food, Scallop
Allergen, Food, Scallop IgG
Allergen, Food, Sesame Seed
Allergen, Food, Shrimp
Allergen, Food, Shrimp IgG
Allergen, Food, Sole IgE
Allergen, Food, Soy
Allergen, Food,Meat Rabbit
Allergen, Food, Spelt
Allergen, Food, Soybean
Allergen, Food, Soybean IgG
Allergen, Food, Spinach
Allergen, Food, Squid IgE
Allergen, Food, Strawberry
Allergen, Food, Strawberry IgG
Allergen, Food, Sugar Cane IgE
Allergen, Food, Summer Squash IgE
Allergen, Food, Sunflower Seed IgE
Allergen, Food, Sweet Potato IgE
Allergen, Food, Swordfish IgE
Allergen, Food, Tea
Allergen, Food, Thyme IgE
Allergen, Food, Tilapia IgE
Allergen, Food, Tomato
Allergen, Food, Trout
Allergen, Food, Tuna
Allergen, Food, Tuna IgG
Allergen, Food, Turkey
Allergen, Food, Turkey IgG
Allergen, Food, Turmeric IgE
Allergen, Food, Vanilla
Allergen, Food, Venus Clam
Allergen, Food, Walleye Pike IgE
Allergen, Food, Walnut IgE
Allergen, Food, Walnut IgG
Allergen, Food, Watermelon IgE
Allergen, Food, Wheat flour
Allergen, Food, Wheat IgG
Allergen, Food, Whey IgE
Allergen, Food, Whey IgG
Allergen, Food, White Pollock IgE
Allergen, Food, Whitefish IgE
Allergen, Food, Whole Egg, IgG
Allergen, Food, Zucchini IgE
Allergen, Tomato IgG
References
Guidelines
- Soares-Weiser K, Takwoingi Y, Panesar SS, Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Halken S, Poulsen L, van Ree R, Vlieg-Boerstra BJ, Sheikh A, EAACI Food Allergy and Anaphylaxis Guidelines Group. The diagnosis of food allergy: a systematic review and meta-analysis. Allergy. 2014; 69(1): 76-86. PubMed
- Eigenmann PA, Beyer K, Burks W, Lack G, Liacouras CA, Hourihane JO, Sampson HA, Sodergren E. New visions for food allergy: an iPAC summary and future trends.Pediatr Allergy Immunol. 2008; 19 Suppl 19: 26-39. PubMed
- NIAID-Sponsored Expert Panel, Boyce JA, Assa’ad A, Burks W, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad H, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons ER, Teach SJ, Yawn BP, Schwaninger JM. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010; 126(6 Suppl): S1-58. PubMed
- Burks W, Jones SM, Boyce JA, Sicherer SH, Wood RA, Assa’ad A, Sampson HA. NIAID-sponsored 2010 guidelines for managing food allergy: applications in the pediatric population. Pediatrics. 2011; 128(5): 955-65. PubMed
- Boyce JA, Assa’ad A, Burks W, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad H, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons ER, Teach SJ, Yawn BP, Schwaninger JM, NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report. J Allergy Clin Immunol. 2010; 126(6): 1105-18. PubMed
- Chinthrajah RS, Tupa D, Prince BT, Block WM, Rosa JS, Singh AM, Nadeau K. Diagnosis of Food Allergy. Pediatr Clin North Am. 2015; 62(6): 1393-408. PubMed
