IgE testing in children is useful when an immediate, IgE-mediated food allergy (e.g., to peanut, egg, milk) is suspected – i.e., symptoms like hives, swelling, or anaphylaxis within minutes of exposure. A specific IgE blood test can support diagnosis but does not replace a thorough history or oral food challenge. Important: a positive IgE alone does not confirm allergy – false positives are common, especially for foods the child tolerates. In children with eczema or suspected non-IgE-mediated reactions (e.g., FPIES), the test is not helpful. IgG tests for food intolerances lack scientific evidence and are rejected by professional societies. Evidence for IgE testing in children is moderate to strong when used selectively. Caveat: overinterpretation of panel tests without clinical context often leads to unnecessary dietary restrictions and malnutrition.
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