King's College London

The European Academy of Allergy and Clinical Immunology (EAACI) have recently published a much anticipated update of the EAACI Guidelines on Food Allergy Diagnosis. Published in Allergy, this important document provides recommendations for best practice to reach an accurate diagnosis for immediate food allergies.

The EAACI Guidelines on Food Allergy Diagnosis had contributions from over 50 experts from top Allergy centres around the world and were led by Professor Alexandra Santos from King’s College London together with Dr Isabel Skypala from the Brompton Hospital in London, Professor George Du Toit from Guy’s and St Thomas’ Hospital and Dr Carmen Riggioni from the National University Hospital and National University of Singapore.

Food allergy affects up to 10% of children and adults and the number of hospital admission for severe allergic reactions to foods has increased over the last few decades. A diagnosis of food allergy requires avoidance of the culprit allergens and often leads to changes to life-style and anxiety related to the fear of accidental allergic reactions. An accurate diagnosis of food allergy is therefore extremely important and the expert group advising on the EAACI Food Allergy Guidelines also included patient representatives, who ensured the patients’ perspectives were taken into account.

An accurate diagnosis of food allergy is extremely important – in the new EAACI Food Allergy Guidelines, clinicians will have clear guidance on the approach to patients with suspected food allergy.

Food allergy diagnosis should start with an allergy focused clinical history, followed by recommended tests. The guidelines introduce the utilization of tests to detect specific IgE antibodies targeting distinct allergen components within the bloodstream and the evaluation of basophil reactivity, the blood cells responsible for triggering allergic reactions. Recently the MRC-funded Basophil Activation Test to Diagnose Food Allergy (BAT2) Study, led by Professor Santos in the Santos Lab, has shown that BAT testing could be used to predict the risk of severe allergic reactions and/or low threshold of reactivity.

The new EAACI Food Allergy guidelines summarise the evidence and the rationale supporting the best practice recommendations for confirming or ruling out the diagnosis in children and adults with possible food allergy.

The guidelines help support healthcare professionals seeing patients with possible food allergies to provide the best possible care. Supporting the diagnosis of immediate type food allergies and provide clear and informed recommendations for best clinical practice.