Food Allergy has become epidemic over the past 2 decades, particularly in children. The scope of indicated allergy testing is very much guided by one’s history and is accomplished by skin and/or blood testing. Most confirmed food allergies justify one’s carrying an epinephrine auto-injector. It is important for you to know situations that would warrant use of the auto-injector, and (of course!) how to use it. Not all convincing reactions to foods involve allergic antibody, however. We can sort out these details with you. Most food allergic reactions start within 2 hours of ingesting the culprit food. In the past few years, however, a newly described condition called “alpha gal allergy” has been described that manifests 3-6 hours or so after ingesting beef, pork, lamb or other such mammalian meats.
Drug Allergies are diagnosed most commonly by history alone. No standardized diagnostic tests exist for most drug allergies. One major exception is penicillin allergy, for which we can provide skin testing. If penicillin skin tests are negative, it is common for the evaluation to then include a challenge dose of amoxicillin given in the office, followed by one or more hours of observation.
A life-threatening systemic allergic reaction, can occur following exposure to ingested or injected allergen (food, drug, bee sting, allergy shot); but can also happen without any discernible trigger (idiopathic anaphylaxis). Spoken tongue-in-cheek, it is our least favorite diagnosis, as we wonder “is there something we’re missing?” History is especially critical, as is diagnostic testing and epinephrine auto-injector contingency.