Late reactions in food-allergic children and adolescents after double-blind placebo-controlled food challenges

Abstract

The time during which children are observed following a double-blind, placebo controlled, food-challenge (DBPCFC) varies in clinical practice. There is little data on late reactions (LRs) following DBPCFCs. Therefore, we determined the prevalence, severity and clinical characteristics of late reactions in food-allergic children and adolescents after DBPCFC, and ascertained which factors are associated with and may predict LRs. Logistic regression analyses were performed to investigate which factors were associated with LRs and to develop association and prediction models. A total of 1142 children underwent DBPCFCs (child-test combinations). Of these 1142 child-test combinations, 400 reported LRs following the DBPCFC. LRs in food-allergic children after DBPCFC are poorly predictable, and are generally not severe. All LRs, including those on the placebo day, are more frequently reported in younger children. Children who do not experience severe immediate reactions may be safely discharged home 2 hours after a DBPCFC.

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