Oral provocation tests in pediatrics: indications, risks and therapeutic experience

L.V. Besh, O.I. Matsiura, V.P. Bobyk


The article presents literature data and therapeutic experience on the use of oral provocation tests. They are considered to be the golden standard for the diagnosis of food allergy and provide an opportunity not only to confirm the pre­sence of the condition, but also to determine the level of to­lerance to the product and to monitor the effectiveness of food desensitization. The risks and indications for oral provocation tests are presented. Difficulties in the results interpretation have also been evaluated. In particular, information about the fact that the mild, subjective, or atypical symptoms of food allergy are most complicated in the evaluation, as they can not only indicate the beginning of the development of serious reactions, but also be the result of the influence of emotional factors. The individual approach to choosing the dose of the food allergen and the interval between its administration during oral provocation tests was described. Our therapeutic experience confirms that symptoms during oral provocation tests predominantly occur after the administration of the allergen in higher doses. And, accordingly, at higher doses, as a rule, there were more severe symptoms of food allergy. A short time interval between the administration of an allergen (less than 30 minutes) can complicate the interpretation of the results and compromise the test. The article presents a clinical case of the oral provocation test in a 7-month-old child, which confirmed the presence of allergy to cow’s milk proteins. This case allows us to trace the peculiarities of the diagnostic investigation and the method of conducting the test at an early age using infant formulas (standard adapted milk and formula with complete protein hydrolysis).


children; oral provocation tests; allergy; tolerance; complete protein hydrolysis formula


Ishkova NS, Kaznacheeva LF, Kaznacheev KS, Dubrovina LN, Gerashchenko NV. The experience of using amino-based mixtures in children with food allergy. Pediatria. Zhurnal imeni Speranskogo GN. 2013;92(4):92-6. (in Russian).

Nedelska SM, Pakholchuk OP, Bessikalo TG. Rational feeding as prophylaxis and treatment of the food allergy in children. Sovremennaya pediatriya. 2012;6(46):113-5. (in Ukrainian).

Shadrin OG, Njan'kovs'kyj SL, Umanec' TR, et al. Recommendations for the management of children with food allergy to cow's milk protein. Dytjachyj likar. 2012;7(20):27-40. (in Ukrainian).

James JM, Burks W, Eigenmann PA. Food allergy. Phyladelphia: Elsevier Saunders, 2012. 368 p. doi: 10.1016/B978-1-4377-1992-5.00021-1.

Dhami S, Nurmatov U, Pajno GB, et al. Allergen Immunotherapy for IgE-mediated food allergy: protocol for a systematic review. Clin Transl Allergy. 2016 Jul 5;6:24. doi: 10.1186/s13601-016-0113-z.

Muraro A, Halken S, Arshad SH, et al. EAACI food allergy and anaphylaxis guidelines. Primary prevention of food allergy. Allergy. 2014 May;69(5):590-601. doi: 10.1111/all.12398. Epub 2014 Apr 3.

Nurmatov U, Devereux G, Worth A, Healy L, Sheikh A. Effectiveness and safety of orally administered immunotherapy for food allergies: a systematic review and meta-analysis. Br J Nutr. 2014 Jan 14;111(1):12-22. doi: 10.1017/S0007114513002353.

Salvilla SA, Dubois AE, Flokstra-de Blok BM, at al. Disease-specific health-related quality of life instruments for IgE-mediated food allergy. Allergy. 2014 Jul;69(7):834-44. doi: 10.1111/all.12427.

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