Dutch guideline on oral food challenges

The diagnosis food allergy is established in case of an immediate allergic reaction less than one year before presentation to a clearly identifiable allergenic food combined with sensitization to this allergenic food. In all other cases, a food challenge test is required to establish or reject the diagnosis of food allergy. Although the double- blind placebo-controlled food challenge (DBPCFC) test is considered the gold standard, false positive and false negative outcomes occur. The percentage of false positive outcomes is unknown because the outcomes of a DBPCFC test cannot be further confirmed by other tests. It is important to perform, if possible, double-blind challenges with recipes that have been validated for blinding and to use challenge procedures that have been proven safe in clinical practice, in order to reduce the risk of unwanted false positive and false negative outcomes and severe reactions during challenges. The national guideline of the Dutch Society of Allergology describes when challenges are indicated and contra-indicated, how food challenges are best conducted and how patients could best be managed and followed-up after the challenge tests have been completed.