Abstract Food allergy is defined as an adverse immunologic response to a food. Immunoglobulin E (IgE)-mediated reactions to foods are associated with a broad range of signs and symptoms that may involve any of the following body systems: the skin, gastrointestinal tract, respiratory tract, and cardiovascular system. IgE-mediated food allergy is a leading cause of anaphylaxis. Therefore, timely and appropriate diagnosis and treatment are imperative. A diagnosis of food allergy entails a careful history and diagnostic tests, which may include skin prick tests, serum-specific IgE, and oral food challenge. The goal of food allergy care is to empower patients and caregivers to manage the risk of food-allergic reactions, reduce food allergy-related anxiety, and achieve a sense of control over their condition. This can be achieved in different ways for different patients and across different life stages. This article provides an overview of the epidemiology, pathophysiology, diagnosis, and management of IgE-mediated food allergy.

Key take-home messages Food allergy is defined as an adverse immunologic response to a food protein. Diagnosis of food allergy requires a detailed history and diagnostic tests, such as SPT and/or food-specific serum IgE measurement, and in some cases, OFCs. Management of food allergy involves avoidance of the culprit food(s) and self-injectable epinephrine for anaphylaxis. For patients with systemic symptoms, the treatment of choice is epinephrine administered by intramuscular injection into the lateral thigh. OIT is indicated as an option for food allergy management, which can be disease-modifying when performed early in the first years of life (see OIT article in this supplement). However, OIT is not readily accessible in many regions.