Panel issues comprehensive US food allergy guidelines

Dec 06, 2010

An expert panel sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has issued comprehensive U.S. guidelines to assist health care professionals in diagnosing food allergy and managing the care of people with the disease.

The Guidelines for the Diagnosis and Management of in the United States: Report of the NIAID-sponsored Expert Panel, developed over two years, are intended for use by both family practice physicians and medical specialists. Published online by the , the guidelines and summary recommendations are freely accessible on the NIAID food allergy guidelines portal at http://www.niaid.nih.gov/topics/foodAllergy/clinical/. NIAID expects to make a lay language synopsis of the guidelines available there in early 2011.

"Food allergy affects millions of Americans, and these individuals seek care from a wide variety of health care providers," says NIAID Director Anthony S. Fauci, M.D. "Because these guidelines provide standardized, concise recommendations on how to diagnose and manage food allergy and treat acute food allergy reactions across specialties, we expect both clinicians and food allergy patients to greatly benefit from these clear state-of-the-science clinical standards."

The guidelines serve to establish consistency in terminology and definitions, diagnostic criteria and patient management practices. They are designed for both generalists and specialists in areas such as allergy, pediatrics, family medicine, internal medicine, dermatology, gastroenterology, emergency medicine, and pulmonary and critical care medicine.

A coordinating committee representing 34 professional organizations, advocacy groups and federal agencies oversaw the development of the guidelines. The coordinating committee selected a 25-member expert panel, chaired by Joshua Boyce, M.D., co-director of the Inflammation and Allergic Disease Research Section at Boston's Brigham and Women's Hospital. The panel used an independent, systematic literature review of food allergy and their own expert clinical opinions to prepare draft guidelines. Public comments were invited and considered as well during the development of the guidelines.

"These guidelines are an important starting point toward a goal of a more cogent, evidence-based approach to the diagnosis and management of food allergy," says Dr. Boyce. "We believe that they provide healthcare professionals with a clear-cut definition of what constitutes a food allergy and a logical framework for the appropriate use of diagnostic testing and accurate interpretation of the results."

Additional topics covered by the guidelines include the prevalence of food allergy, natural history of food allergy and closely associated diseases, and management of acute allergic reactions to food, including anaphylaxis, a severe whole-body reaction. They also identify gaps about what is known about food allergy.

"The food allergy provide a rigorous assessment of the state of the science, and clearly identify the areas where evidence is lacking and where research needs to be pursued," says Daniel Rotrosen, M.D., director of the Division of Allergy, Immunology and Transplantation at NIAID. "This information will help shape our research agenda for the near future."

Food allergy has become a serious health concern in the United States. Recent studies estimate that food allergy affects nearly 5 percent of children younger than 5 years old and 4 percent of teens and adults. Its prevalence appears to be on the rise. Not only can food allergy be associated with immediate and sometimes life-threatening consequences, it also can affect an individual's health, nutrition, development and quality of life. While several potential treatments appear promising, currently no treatments for food allergy exist and avoidance of the food is the only way to prevent complications of the disease.

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