Ask the allergist is a regular feature in our newsletters where Dr. Julia Upton answers your questions!
Dr. Julia Upton is a Canadian allergist who is on staff at Toronto’s SickKids Hospital in the Immunology and Allergy Department. She is an Associate Professor in the Department of Paediatrics at the University of Toronto and is the past Section Chair of Food Allergy and Anaphylaxis with the CSACI. Dr. Upton is also a member of our Healthcare Advisory Board.
Please note: Dr. Upton is answering as an individual allergist and her answers do not constitute an official position of her affiliated organizations. Her responses are for informational purposes only and do not constitute specific medical advice, recommendations, diagnosis, or treatment. Please talk to your doctor about any concerns or questions you may have regarding your own health or the health of your child.
This month she answers your question about the re-evaluation of a previously diagnosed food allergy.
Q. My son has been diagnosed with allergies to peanut and tree nuts. How often should he be re-evaluated?
Evaluation by an allergist happens for a number of reasons.
Firstly, the allergist can establish whether a child is likely to be allergic to a food by taking the clinical history and conducting allergy testing. Sometimes it is not clear if it’s a food allergy and there may be a recommendation to do an oral food challenge (OFC) to confirm it.
Most children are not allergic to peanuts and all tree nuts. In this case, there may be an opportunity to refine the diagnosis to only the foods to which he is truly allergic. This refinement may take multiple visits and may include blood work and OFCs.
After diagnosis, reasons for follow up are to see if a child has outgrown an allergy and to ensure management is appropriate. Allergists often like to recheck food allergies yearly to see if a child may have outgrown any. For older children and adults, they are less likely to outgrow the allergies so the allergist may recommend they be re-assessed every other year.
For daily management, this may include counselling for avoidance or it may include the emerging use of oral immunotherapy (OIT). Therefore, the frequency of follow up will vary depending on the type of management.
Some children also have eczema, asthma and/or environmental allergies which may require more frequent follow up.
Do you have a question you’d like to ask Dr. Upton in the months to come? If so, please send it along to us at info@foodallergycanada.ca. Please note: Dr. Upton answers questions on general topics, please talk to your doctor if you have questions about your own health or the health of your child.
Tags: ask the allergist, diagnosis, Peanut, tree nut