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Food allergy
What's new
Updated 2025 EAACI guidelines for the management of IgE-mediated food allergy .
Background
Overview
Definition
Food allergy is an adverse food-stimulated immune response initiated on exposure to a given food.
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Pathophysiology
Food allergy is mostly caused by IgE-mediated antibodies (type 1 or early; 48%) and IgE-independent immune response including type IV (18%), type III (10%), and type II (6%) to specific foods (milk, eggs, wheat, fish, soy, peanuts, fish, shellfish, cherries, peaches, plums, apricots, nuts, and seeds) influenced by genetic and environmental (improved hygiene, lifestyle, diet and nutrition) factors.
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Epidemiology
The prevalence of IgE-mediated food allergy in the US is estimated at 10,000 in 100,000 adults.
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Disease course
Clinical manifestations of an immediate reaction include anaphylactic shock, urticaria, and angioedema. Late reaction food reaction symptoms include fatigue, irritability, depression, hyperactivity, insomnia, headache, poor concentration, paleness, itching limbs, involuntary bedwetting, asthma, colds, indigestion, colic, diarrhea, bloating, and skin lesions. The disease impairs QoL necessitating lifelong prevention of the specific food.
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Prognosis and risk of recurrence
The mortality risk associated with fatal anaphylaxis is < 1%.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of food allergy are prepared by our editorial team based on guidelines from the European Academy of Allergy and Clinical Immunology (EAACI 2025,2023,2021,2018,2014), the American Academy of Allergy, Asthma & Immunology (AAAAI 2024,2020), the American Academy of Family Physicians (AAFP 2023), the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN ...
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