Food allergies in adults

  • Amornrat Prasertcharoensuk
Keywords: food allergies, adulthood, Oral allergy syndrome, Food associated exercise-induced anaphylaxis


Food allergies are an abnormal immune response to food and important conditions, especially among food allergies in adults. Disease progression and food allergens for adults are different than those of children. Food intolerance is often mistaken for a food allergy. Specialists are required to make the diagnosis. This article reviews food allergies related to the immune system, both IgE-mediated and cell mediated response. Some types of food allergies in adults, such as food associated exercise-induced anaphylaxis or oral allergy syndrome, would not be found in children. This review provides relevant symptoms and the diagnosis of food allergies in adults that may be helpful for further education and practice.


Download data is not yet available.


1. Chafen JJ, Newberry SJ, Riedl MA, et al. Diagnosing and managing common food allergies: a systematic review. Jama 2010;303:1848-56.
2. Burks AW, Tang M, Sicherer S, et al. ICON: food allergy. J Allergy Clin Immunol 2012;129:906-20.
3. Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. Nutr Res 2011;31: 61-75.
4. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol 2011;127:594-602.
5. Gupta RS, Springston EE, Warrier MR, et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 2011;128: e9-17.
6. Soller L, Ben-Shoshan M, Harrington DW, et al. Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol 2012;130:986-8.
7. Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a metaanalysis. J Allergy Clin Immunol 2007;120:638-46.
8. Rangkakulnuwat P, Sutham K, Lao-Araya M. Anaphylaxis: Ten-year retrospective study from a tertiary-care hospital in Asia. Asian Pac J Allergy Immunol 2020;38:31.
9. Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 2014;133:291-307;quiz8.
10. Savage J, Sicherer S, Wood R. The Natural History of Food Allergy. J Allergy Clin Immunol Pract 2016;4:196-203; quiz 4.
11. Ochfeld EN, Pongracic JA. Food allergy: Diagnosis and treatment. Allergy Asthma Proc 2019;40:446-9.
12. Kamdar TA, Peterson S, Lau CH, et al. Prevalence and characteristics of adultonset food allergy. J Allergy Clin Immunol Pract 2015;3:114-5.e1.
13. Begin P, Chan ES, Kim H, et al. CSACI guidelines for the ethical, evidence-based and patient-oriented clinical practice of oral immunotherapy in IgE-mediated food
allergy. Allergy Asthma Clin Immunol 2020;16:20.
14. Iweala OI, Choudhary SK, Commins SP. Food Allergy. Curr Gastroenterol Rep 2018;20:17.
15. Katelaris CH. Food allergy and oral allergy or pollen-food syndrome. Curr Opin Allergy Clin Immunol 2010;10:246-51.
16. Mahdavinia M. Food Allergy in Adults: Presentations, Evaluation, and Treatment. Med Clin North Am 2020;104:145-55.
17. Visness CM, London SJ, Daniels JL, et al. Association of obesity with IgE levels and allergy symptoms in children and adolescents: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol 2009;123:1163-9, 9.e1-4.
18. Capucilli P, Hill DA. Allergic Comorbidity in Eosinophilic Esophagitis: Mechanistic Relevance and Clinical Implications. Clin Rev Allergy Immunol 2019;57:111-27.
19. Gupta RS, Warren CM, Smith BM, et al. Prevalence and Severity of Food Allergies Among US Adults. JAMA Netw Open 2019;2:e185630.
20. Sicherer SH, Warren CM, Dant C, et al. Food Allergy from Infancy Through Adulthood. J Allergy Clin Immunol Pract 2020;8:1854-64.
21. Kleine-Tebbe J, Wassmann-Otto A, Monnikes H. [Food Allergy and Intolerance: Distinction, Definitions and Delimitation]. Bundesdedundheitsbla 2016;59:705-22.
22. Sampson HA, Aceves S, Bock SA, et al. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol 2014;134:1016-25.e43.
23. Chomchai S, Chomchai C. Histamine poisoning from insect consumption: an outbreak investigation from Thailand. Clin Toxicol (Phila) 2018;56:126-31.
24. Skypala IJ, Williams M, Reeves L, et al. Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence. Clin Transl Allergy 2015;5:34.
25. Hodge L, Swain A, Faulkner-Hogg K. Food allergy and intolerance. Aust Fam Physician 2009;38:705-7.
26. Lam HY, van Hoffen E, Michelsen A, et al. Cow’s milk allergy in adults is rare but severe: both casein and whey proteins are involved. Clin Exp Allergy 2008;38:995-
27. Ugidos-Rodríguez S, Matallana-González MC, Sánchez-Mata MC. Lactose malabsorption and intolerance: a review. Food Funct 2018;9:4056-68.
28. Fiocchi A, Dahdah L, Albarini M, et al. Cow’s milk allergy in children and adults. Chem Immunol Allergy 2015;101:114-23.
29. Fiocchi A, Dahda L, Dupont C, et al. Cow’s milk allergy: towards an update of DRACMA guidelines. World Allergy Organ J 2016;9:35.
30. Wong GK, Krishna MT. Food-dependent exercise-induced anaphylaxis: is wheat unique? Curr Allergy Asthma Rep 2013;13:639-44.
31. Cianferoni A. Wheat allergy: diagnosis and management. J Asthma Allergy 2016;9:13.
32. Morita E, Matsuo H, Chinuki Y, et al. Fooddependent exercise-induced anaphylaxisimportance of omega-5 gliadin and HMWglutenin as causative antigens for wheatdependent exercise-induced anaphylaxis. Allergol Int 2009;58:493-8.
33. Brisman J. Baker’s asthma. Occup Environ Med 2002;59:498-502;quiz,426.
34. T h o n g k h o m R , O n c h a m S , Sompornrattanaphan M, et al. Banana anaphylaxis in Thailand: case series. Asia Pac Allergy 2020;10:e4.
35. Sanchez-Borges M, Suarez-Chacon R, Capriles-Hulett A, et al. Pancake syndrome (oral mite anaphylaxis). World Allergy Organ J 2009;2:91
36. Hilger C, Fischer J, Wolbing F, et al. Role and Mechanism of Galactose-Alpha-1,3- Galactose in the Elicitation of Delayed Anaphylactic Reactions to Red Meat. Curr Allergy Asthma Rep 2019;19:3.
37. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, et al. EAACI Molecular Allergology User’s Guide. Pediatr Allergy Immunol 2016;27 (Suppl 23) 23:1-250.
38. Wongrakpanich S, Klaewsongkram J, Chantaphakul H, et al. Jackfruit anaphylaxis in a latex allergic patient. Asian Pac J Allergy Immunol 2015;33:65-8.
39. Stirapongsasuti P, Tanglertsampan C, Aunhachoke K, et al. Anaphylactic reaction to phuk-waan-ban in a patient with latex allergy. J Med Assoc Thai 2010;93:616-9.
40. Borres MP, Maruyama N, Sato S, et al. Recent advances in component resolved diagnosis in food allergy. Allergol Int 2016;65:378-87.
41. Asaumi T, Yanagida N, Sato S, et al. Provocation tests for the diagnosis of food-dependent exercise-induced anaphylaxis. Pediatr Allergy Immunol 2016;27:44-9.
42. Brockow K, Kneissl D, Valentini L, et al. Using a gluten oral food challenge protocol to improve diagnosis of wheatdependent exercise-induced anaphylaxis.J Allergy Clin Immunol 2015;135:977-84.e4.
43. Pavicic Saric J, Zenko J, Bevanda M, et al. Liver transplantation and allergy: transplant-acquired food allergy. Psychiatr Danub 2019;31:63-5.
44. Dreskin SC, Halsey NA, Kelso JM, et al. International Consensus (ICON): allergic reactions to vaccines. World Allergy Organ J 2016;9:32.
Review Article (บทความวิชาการ)