PT - JOURNAL ARTICLE AU - Cirsten Groen AU - Paul Brand TI - Respiratory symptoms during double blind placebo controlled food challenges in children in a general paediatric clinic DP - 2012 Sep 01 TA - European Respiratory Journal PG - P1106 VI - 40 IP - Suppl 56 4099 - http://erj.ersjournals.com/content/40/Suppl_56/P1106.short 4100 - http://erj.ersjournals.com/content/40/Suppl_56/P1106.full SO - Eur Respir J2012 Sep 01; 40 AB - Although double blind placebo controlled food challenges (DBPCFC) are the gold standard for the diagnosis of food allergy, a risk factor for severe asthma, studies examining respiratory symptoms during DBPCFC have come from children with severe eczema in specialized allergy centres. We examined the occurrence of respiratory symptoms during DBPCFC in children referred for evaluation of food allergy to a paediatric department in a general teaching hospital.Between 2006 and 2011, we performed 234 DBPCFCs to cow's milk, hen's egg, peanut, hazelnut, and soy in children 2 months-17 years of age (median 22 months). 85 tests were positive (36.3%). The symptoms on which food allergy suspicion was based included respiratory symptoms in 55 cases (23.5%), and were accompanied by symptoms from other organs in 54. Respiratory symptoms were seen on the placebo day in 8 patients (3.4%) and on the verum day in 23 patients (9.9%, p<0.001): rhinitis in 11, stridor in 3, wheeze in 6, and dyspnoea and cough in 16. None of these 23 patients had respiratory symptoms on the placebo day; 22 also had symptoms of other organ systems. The only patient with only respiratory symptoms (dyspnoea without wheeze) on the verum day had a negative DBPCFC to cow's milk, because his symptoms on the verum day did not match the symptoms at referral (erythema, vomiting, diarrhoea). Only 4 patients required bronchodilator treatment.In a general paediatric clinic, respiratory symptoms rarely occur in DBPCFC, and respiratory symptoms are never the only manifestation of food allergy in children.