referral criteria from primary care - food allergy

Last reviewed 01/2018

Referral to secondary or specialist care

Based on the allergy-focused clinical history, consider referral to secondary or specialist care in any of the following circumstances

The child or young person has:

• faltering growth in combination with one or more of the gastrointestinal symptoms
  • gastrointestinal

• IgE-mediated	non-IgE-mediated
  angioedema of the lips, tongue and palate	gastro-oesophageal reflux disease
  oral pruritus	loose or frequent stools
  nausea	blood and/or mucus in stools
  colicky abdominal pain	abdominal pain
  vomiting	infantile colic
  diarrhoea	food refusal or aversion
  	constipation
  	perianal redness
  	pallor and tiredness
  	faltering growth in conjunction with at least one or more gastrointestinal symptoms above (with or without significant atopic eczema)

  
  
  
• or not responded to a single-allergen elimination diet, or
  
  
• had one or more acute systemic reactions, or
  
  
• had one or more severe delayed reactions, or
  
  
• has confirmed IgE-mediated food allergy and concurrent asthma , or
  
  
• has significant atopic eczema where multiple or cross-reactive food allergies are suspected by the parent or carer

Referral for specialist advice is also indicted if either there is:

• persisting parental suspicion of food allergy (especially in children or young people with difficult or perplexing symptoms) despite a lack of supporting history, or
• strong clinical suspicion of IgE-mediated food allergy but allergy test results are negative, or
• clinical suspicion of multiple food allergies

Reference:

• 1) NICE (February 2011).Food allergy in children and young people Diagnosis and assessment of food allergy in children and young people in primary care and community settings