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Objectives Oral food challenges (OFC) play an important role in the diagnosis and assessment of food allergy. This analysis was performed to identify the outcomes of OFC conducted during the last 2 years. Methods A comprehensive retrospective analysis was undertaken, encompassing all hospital-based OFC database, conducted between January 2021 and December 2022 at Oxford University Hospitals NHS Foundation Trust. Results Among 202 OFC, tree nut challenges were the most common (38.1%), followed by peanut (25.2%), egg (12.37%), and milk (8.9%). The overall non-reaction rate was 78.21%, with tree nut, milk, and peanut challenges yielding non-reaction rates of 89.61%, 83.33%, and 74.51%, respectively. Notably, egg challenges exhibited a higher reaction rate (52%), with baked egg challenges faring worse at 45%. Reactions occurred in 15.84% of cases, the majority manifesting as hives (50%), respiratory symptoms (31.25%), or gastrointestinal issues (43.75%). One case necessitated treatment for anaphylaxis. Conclusion This review underscores the pivotal role of OFC in enabling families to include food back to their diet. Our review identified tree nuts as the common allergen used in these challenges. We adopted allergy society guidelines and recommended most families to undertake home egg challenges for low-risk patients and therefore patients selected for hospital-based egg challenge were deemed at high risk. The ability to include food back to their diet plays a significant role in enhancing the quality of life for children and adolescents suffering from food allergies. There was a low reaction rate observed in our clinic. This may indicate there is risk avoidance in the selection of patients for food challenges. Strategies to select patients suitable for home challenges will enable to utilize this valuable resource more efficiently. This approach aims to ensure a more nuanced and effective strategy in managing food allergies among young patients.
Suriapperuma et al. (Tue,) studied this question.