Documentation of the rate, spectrum, and predictors of positive reactions is instructive.
Methods:
Children, who underwent OFC between January 1, 2017 and December 31, 2019 were analyzed. Results A total of 1361 OFCs in 613 cases were reviewed. Most of them were performed in preschool children (≤2 years 50%) and 55% of them had more than one OFC. Mainly considered food groups were cows milk (31.8%), hens egg (28.5%), treenuts (20%), legumes (7%), seeds (4.9%), and wheat (2.7%). The overall OFC positivity was 9.6%, whereas 6.7% with cows milk, 4.9% with hens egg, 16.1% with treenuts, 21.6% with wheat, and 32.8% with seeds. The severity scoring revealed grade I (24.4%), II (45.8%), and III (29.7%) reactions. Fifty (38%) cases required epinephrine and four cases required hospitalization. OFCs with sesameseeds (odds ratio [OR] 7.747, [confidence interval (CI) 95% 4.0314.90]), wheat (OR 3.80, [CI 1.648.84]), and treenuts (OR 2.78, [CI 1.834.23]) predicted a positive OFC while a concomitant asthma (OR 3.61 [CI 1.2710.28]) was more likely to elicit anaphylaxis. Conclusion In OFC practice, priority is given to basic nutritional sources and the most frequent foodallergens, where preschool children with multiple sensitizations are the primary subjects. Increased risks of positive reactions with sesame, treenut, and wheat and increased risk of anaphylaxis with concomitant asthma should be considered while performing OFC (AU)