Blind food challenge testing with wide-open eyes
Bahna, S.L.
Annals of Allergy 72(3): 235-238
1994
ISSN/ISBN: 0003-4738 PMID: 8129216 Document Number: 429339
A review. Because food allergy treatment is basically avoidance of the offending food(s), identification of the latter becomes the cornerstone for management. At present, the elimination-challenge test is the most definitive procedure for verification of a cause-effect relation between a particular food and a certain reaction, allergic or otherwise. The oral challenge test is most reliable when conducted in a double-blind, placebo controlled manner. In routine clinical practice, however, single-blind testing is satisfactory in most cases. Open challenge testing might be acceptable in young children or for screening the least suspected foods. It is advisable to avoid the test, in any of its forms, where a specific food could cause a life-threatening reaction. Caution is needed in planning, conducting, and interpreting the results of challenge tests. Difficulties may be encountered in disguising the test food, choosing a placebo, reproducing the natural exposure, incorporating possible associated factors, and avoiding any bias on the patient's or observer's part.