In cases of allergic eosinophilic esophagitis, a biopsy may need to be performed. Elimination diets with gradual reintroduction of foods and supervised oral food challenges are often needed to help identify the causative foods.
Simple tests for food-specific immunoglobulin E (IgE) antibodies are available, but the clinician must appreciate that a positive test for food-specific IgE primarily denotes sensitization and may not confirm clinical allergy. A physician-supervised oral food challenge may be required for diagnosis. Because specific laboratory tests for some food hypersensitivities are not available, diagnosing non–IgE-mediated food allergies (eg, cow milk–induced and soy-induced enterocolitis syndromes) is more difficult than diagnosing IgE-mediated food allergies. The concentration of food-specific IgE does not correlate very well with the severity of an allergy.
For more on the workup of food allergies, read here.
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Cite this: Stephen Soreff, B.S. Anand, Scott H. Sicherer, et. al. Fast Five Quiz: Can You Answer These Challenging Primary Care Questions? - Medscape - Mar 13, 2017.
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