Descriptive analysis of oral food challenge outcomes at a tertiary care center

Results We assessed 113 challenges (35 peanut, 28 egg, 12 tree nut, 11 milk, 27 other). There were 29 failures (22 objective, 7 subjective). Among objective challenge failures, 4/7 cashew (57%), 10/35 (29%) peanut, and 6/28 egg (21%) failed. There were no failed milk challenges. Most (79%) failed peanut/cashew challenges occurred at doses ≤1.0g while 50% of failed egg challenges were final dose (10g). Three children required epinephrine (all cashew), none of whom had a prior known exposure (skin tested 2° peanut/ almond). For peanut failures, 40% were history negative. The remainder of the challenge failure reactions were similar to the presenting reaction. Factors for failed challenges compared with successful challenges included atopic dermatitis (100% v 75%), asthma (93% v 63%), and other food allergy (64% v 48%).