Food panels no longer available

Food panel testing

Food panel testingIn conjunction with our Allergy and Immunology division, Children’s Wisconsin laboratory will be eliminating food allergy panels from Epic and the laboratory catalog. Although many practitioners are accustomed to the ease of ordering a single food or order set, or preselected order set, the downfalls of broad panel testing for food allergy are numerous. First, use of serum IgE as a screening test for food allergy is not recommended, because there is a very low positive predictive value. Second, there can be numerous false positive test results found on panel testing (while up to 30 percent of people are sensitized, only 8 percent have true IgE-mediated allergy). Third, the results can have several unintended (and potentially avoidable) consequences, including: overdiagnosis or misdiagnosis of food allergy; unnecessary dietary elimination; nutritional consequences; unnecessary anxiety; and increased health care costs.

Food panels are not helpful — and are potentially harmful — in the work-up of the food allergic patient. Additionally, food panels should not be done in the evaluation of atopic dermatitis (eczema), hives or non-specific gastrointestinal concerns.

The Allergy and Immunology Clinic is available to help you and your patients if you are concerned about food allergy or any other atopic condition(s). Individual (food-specific) IgE levels will still be orderable through Children’s Epic, Epic Care Link or by using our outpatient laboratory form.

If you have any questions about this update, contact your physician liaison.

References

1) Kraft, M.T., Wilson, J., Leber, A.L., Stukus, D.R., Scherzer, R., 2020. Review of ordering practices for single-allergen and serum-specific Immunoglobulin E panel tests for food allergy. Annals of Allergy, Asthma & Immunology 125, 343–344. doi:10.1016/j.anai.2020.05.023

2) Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018 Jan;141(1):41-58. doi: 10.1016/j.jaci.2017.11.003. Epub 2017 Nov 21. PMID: 29157945.

3) Sicherer SH, Allen K, Lack G, et al. Critical Issues in Food Allergy: A National Academies Consensus Report. Pediatrics. 2017;140(2): e20170194

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