PURPOSE OF THE STUDY.
To investigate the self-reported impact of a double-blind, placebo-controlled food challenge (DBPCFC) on the health-related quality of life (HRQL) of children, adolescents, and adults with food allergy.
Children 8 to 12 years old (n = 77), adolescents 13 to 18 years old (n = 71), and adults (n = 73) with clinical suspicion of food allergy who were awaiting DBPCFC. Because there was a long wait time for DBPCFCs, the designated experimental group was expected to have a wait of <6 months and the control group was expected to have a >6-month wait.
Age group–specific, validated, reliable, and discriminative food allergy quality of life (QoL) questionnaires were used. The self-reported forms were completed before and 6 months after DBPCFC in the experimental group and twice by the control group with a 6- to 7-month interval.
For children and adults, the greatest improvement in HRQL score came after a negative DBPCFC when there were no other remaining food allergies. There was a smaller but still significant improvement in HRQL after a positive challenge. There was no significant change after a questionable challenge outcome. HRQL scores did not change in the age-matched control groups. For adolescents, HRQL improved only after a negative DBPCFC.
Greater improvements were seen in food-specific QoL after a negative food challenge than after a positive challenge.
It comes as no surprise that a negative food challenge improves food-specific quality of life. Of interest, even a positive challenge improved QoL in children and adults. It is possible that their recognition of what would happen in the event of an unintentional ingestion removed the uncertainty with which they had lived on a daily basis. The same was not seen in teenagers with a positive challenge, suggesting that their QoL concerns lay more with the fact that they have food allergy than what would happen with ingestion. An important point about this article is that food allergy affects QoL. As common as food allergy is, it is clear that many patients are diagnosed solely on the basis of a positive skin- or serum-specific immunoglobulin E level. The distinction between sensitization and allergy is paramount. Patients with an uncertain history or positive test result in the absence of a positive history should be considered for food challenge in a controlled setting by those experienced with the procedure.
- Copyright © 2013 by the American Academy of Pediatrics