How Allergy Testing Can Lead to More Allergies

Dr. Dave Stutkus shared some slides (on twitter) recently based on a lecture at Nationwide Children’s.  Since I see children everyday who are undergoing poorly-conceived allergy testing, I wanted to share some of them.

  • Excluding foods from diet based on allergy testing without concurrent symptoms can lead to allergies rather than tolerance:

  • Newer antihistamines are safer

  • Most individuals with penicillin allergy are not truly penicillin allergic.  Also, there is a low rate of cross-reactivity with most cephalosporins.

  • Proper allergy testing relies on the basic understanding that sensitization is not equivalent to being allergic.  In addition, allergy testing has a high rate of false positives; therefore, testing needs to be limited (avoid broad panels).

Also, link to AAP guidelines on breastfeeding & eczema and introduction of foods to minimize development of allergies: The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary
Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods

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