Title
Frequency, severity and causes of unexpected allergic reactions to food: A systematic literature review
Author
Versluis, A.
Knulst, A.C.
Kruizinga, A.G.
Michelsen, A.
Houben, G.F.
Baumert, J.L.
van Os-Medendorp, H.
Publication year
2015
Abstract
Summary: Food allergic patients have to deal with an avoidance diet. Confusing labelling terms or precautionary labels can result in misinterpretation and risk-taking behaviour. Even those patients that strictly adhere to their diet experience (sometimes severe) unexpected allergic reactions to food. The frequency, severity and causes of such reactions are unknown. The objective of this review was to describe the frequency, severity and causes of unexpected allergic reactions to food in food allergic patients aged > 12 years, in order to develop improved strategies to deal with their allergy. A systematic review was carried out by two researchers, in six electronic databases (CINAHL, Cochrane, EMBASE, Medline, Psychinfo and Scopus). The search was performed with keywords relating to the frequency, severity and causes of unexpected allergic reactions to food. This resulted in 24 studies which met the inclusion criteria; 18 observational and six qualitative studies. This review shows that knowledge about the frequency of unexpected reactions is limited. Peanut, nuts, egg, fruit/vegetables and milk are the main causal foods. Severe reactions and even fatalities occur. Most reactions take place at home, but a significant number also take place when eating at friends' houses or in restaurants. Labelling issues, but also attitude and risky behaviour of patients can attribute to unexpected reactions. We conclude that prospective studies are needed to get more insight in the frequency, severity, quantity of unintended allergen ingested and causes of unexpected allergic reactions to food, to be able to optimize strategies to support patients in dealing with their food allergy. Although the exact frequency is not known, unexpected reactions to food occur in a significant number of patients and can be severe. For clinical practice, this means that patient education and dietary instructions are necessary. © 2014 John Wiley & Sons Ltd.
Subject
Life
RAPID - Risk Analysis for Products in Development
ELSS - Earth, Life and Social Sciences
Biomedical Innovation
Biology
Healthy Living
Almond
Celery
Crustacea
Disease severity
Fatality
Food allergy
Fruit
Hazelnut
Lupin
Milk allergy
Mollusc
Mustard
Patient education
Peanut
Peanut allergy
Review
Shellfish
Soybean
Vegetable
Walnut
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DOI
https://doi.org/10.1111/cea.12328
TNO identifier
524113
ISSN
0954-7894
Source
Clinical and Experimental Allergy, 45 (2), 347-367
Document type
article