D2.215 - Retrospective evaluation of the outcome of 106 oral food challenges performed in 2017 to 2024

Oral food challenge (OFC) is considered to be the best method for diagnosing food allergy. The aim of our study was to evaluate retrospectively the results of OFCs performed during the study period in terms of their outcome, the nature of symptoms elicited, and the ability of other methods to predict the outcome of OFC. 

Retrospectively, we evaluated OFCs performed at our department in 2017 to 2024 in terms of their outcome and its relationship to the results of other methods such as skin prick tests (SPT) and specific IgE (sIgE) testing to food extract and/or allergenic components.

In the reporting period, we performed 106 OFCs in 81 patients (55 males and 26 females, median age 2 years). The most frequently, OFCs were performed with cow's milk (n = 39), hen's egg (n = 30), and wheat (n = 12). A total of 103 OFCs was completed. Positive reactions were in 28 OFCs: 26 were immediate and 2 were delayed reactions. The most common positive results of OFC were with cow's milk (n = 11), hen’s egg (n = 8), wheat (n = 3), and peas (n = 3). Clinical symptoms were mostly cutaneous (n = 23), followed by gastrointestinal (n = 9) or respiratory (n = 9); only one reaction was associated with cardiovascular symptoms. The relationship of the results of other tests (SPT, sIgE) to the OFC results was very heterogeneous and did not reach statistical significance in most cases.

In the diagnosis of food allergy or tolerance, OFC cannot be fully replaced by the other methods such as SPT or sIgE testing. If OFC is well performed and properly indicated, it is a method that is relatively easy to perform and appropriately safe.