Skip to Main Content

Jon B. Tingelstad Conference: Practical Pediatrics 2025

June 5-6, 2025

Conference Brochure

                                                                            

Allergy Testing: To Test or Not To Test?

Here's a brief bullet point list for "Allergy Testing: To Test or Not To Test in pediatric patients":

Consider Testing When:

  • History suggests IgE-mediated reactions (rapid onset, hives, swelling, breathing issues) to specific foods.
  • Persistent moderate to severe eczema despite optimized topical therapy.
  • Suspected respiratory allergies (rhinitis, asthma) with specific triggers.
  • Guiding introduction of allergenic foods in high-risk infants (with caution and provider guidance).
  • Monitoring resolution of known food allergies (following specific protocols).
  • Documenting allergic sensitization for school or daycare.

Consider Not Routinely Testing When:

  • Mild, non-specific symptoms without a clear allergic trigger.
  • Solely for food avoidance without a history of reaction.
  • Screening general population without clinical suspicion.
  • Positive test is likely to lead to unnecessary food restriction and anxiety.

Factors Favoring Testing:

  • Clear history of an allergic reaction.
  • Need to confirm a suspected allergy for management and avoidance.
  • Guiding OIT candidacy or monitoring progress.

Factors Against Routine Testing:

  • High rate of false positives (sensitization without clinical allergy).
  • Testing can be anxiety-provoking and costly.
  • May lead to unnecessary dietary restrictions impacting nutrition and quality of life.

Testing Methods:

  • Skin Prick Testing (SPT): Quick, relatively inexpensive, good for IgE-mediated allergies.
  • Specific IgE Blood Tests: Useful when SPT is not feasible (e.g., severe eczema, antihistamine use).
  • Oral Food Challenge (OFC): Gold standard for diagnosing or ruling out food allergies, done under medical supervision.

Importance of Clinical Correlation: Test results must always be interpreted in the context of the patient's history and physical exam. A positive test alone does not equal a clinical allergy.

Shared Decision-Making: Discuss the risks and benefits of testing with the family to make an informed decision.

Source: Google Gemini

Items 1-8 of 8 (Display the 8 citations in PubMed)

1.

Development of a clinical predictive score for allergic reactions during oral food challenges in pediatric patients.

Pattarakiatjaroen M, Yuenyongviwat A, Sangsupawanich P.

PLoS One. 2025 Apr 24;20(4):e0322152. doi: 10.1371/journal.pone.0322152. eCollection 2025.

PMID: 40273156 Free PMC article.

2.

Natural history of sesame allergy in pediatric patients: Insight from a retrospective analysis.

Kazancioglu A, Ocak M, Sahiner UM, Soyer O, Sekerel BE.

Pediatr Allergy Immunol. 2025 Jan;36(1):e70022. doi: 10.1111/pai.70022.

PMID: 39754471 Free PMC article.

3.

Atopic dermatitis pediatric patients show high rates of nasal and intestinal colonization by methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci.

Augusto de Oliveira MF, Agne DB, Bastos LSS, Andrade de Oliveira LM, Saintive S, Goudouris ES, do Prado EA, Fragoso Dos Santos H, da Silva Pereira R, Cavalcante FS, de Carvalho Ferreira D, Dos Santos KRN.

BMC Microbiol. 2024 Jan 29;24(1):42. doi: 10.1186/s12866-023-03165-5.

PMID: 38287251 Free PMC article.

4.

The effectiveness of interventions that support penicillin allergy assessment and delabeling of adult and pediatric patients by nonallergy specialists: a systematic review and meta-analysis.

Powell N, Stephens J, Kohl D, Owens R, Ahmed S, Musicha C, Upton M, Kent B, Tonkin-Crine S, Sandoe J.

Int J Infect Dis. 2023 Apr;129:152-161. doi: 10.1016/j.ijid.2022.11.026. Epub 2022 Nov 28.

PMID: 36450321 Free PMC article. Review.

5.

Hypersensitivity to Ibuprofen: Real-Life Experience in Children with History of Suspected Immediate Reactions.

Sipahi Cimen S, Yucel E, Suleyman A, Hizli Demirkale Z, Ozceker D, Sayili U, Guler N, Tamay Z.

Int Arch Allergy Immunol. 2023;184(1):33-42. doi: 10.1159/000526981. Epub 2022 Oct 25.

PMID: 36282068

6.

Contact sensitization in pediatric patients with atopic dermatitis: a purpose for a new patch testing series for the Portuguese population.

Costa Carvalho J, Coutinho IA, Loureiro C, Cordeiro AC, Ramos L, Gonçalo M.

Eur Ann Allergy Clin Immunol. 2024 Jan;56(1):9-16. doi: 10.23822/EurAnnACI.1764-1489.258. Epub 2022 Jun 9.

PMID: 35686363

7.

Pulmonary function evaluation in pediatric patients with primary immunodeficiency complicated by bronchiectasis.

Chiu CC, Wang CJ, Lee WI, Wong KS, Chiu CY, Lai SH.

J Microbiol Immunol Infect. 2020 Dec;53(6):1014-1020. doi: 10.1016/j.jmii.2020.01.006. Epub 2020 Feb 13.

PMID: 32094076

8.

Hypersensitivity to tetracyclines: Skin testing, graded challenge, and desensitization regimens.

Maciag MC, Ward SL, O'Connell AE, Broyles AD.

Ann Allergy Asthma Immunol. 2020 Jun;124(6):589-593. doi: 10.1016/j.anai.2020.02.007. Epub 2020 Feb 20.

PMID: 32087343 Free PMC article.

Top 10 Questions PCP’s Ask About Managing Pediatric Obesity

Here are 10 common questions Primary Care Physicians (PCPs) often ask about managing pediatric obesity:

  1. How do I effectively screen and diagnose pediatric obesity beyond just BMI? (e.g., waist circumference, growth charts, considering body composition).
  2. What are the first-line lifestyle modifications I should recommend for families? (e.g., dietary changes, physical activity goals, screen time limits).
  3. How can I have sensitive and productive conversations with children and families about weight? (Avoiding blame, focusing on health, motivational interviewing techniques).
  4. When should I consider pharmacotherapy for pediatric obesity, and what are the current guidelines and approved medications?
  5. What are the indications and contraindications for bariatric surgery in adolescents, and what is the PCP's role in referral and follow-up?
  6. How do I address common co-morbidities of pediatric obesity in primary care? (e.g., prediabetes, hypertension, dyslipidemia, NAFLD).
  7. What are some practical strategies for supporting families with limited resources or cultural differences in making healthy changes?
  8. How often and what should be included in follow-up visits for children with obesity? (Monitoring progress, adjusting plans, addressing barriers).
  9. What community resources and specialists should I be aware of for referral and collaborative care? (e.g., dietitians, behavioral health professionals, exercise physiologists).
  10. How can I stay up-to-date on the rapidly evolving guidelines and research in pediatric obesity management?

Source: Google Gemini

Items 1-10 of 10 (Display the 10 citations in PubMed)

1.

Estimated Costs and Cost-Effectiveness of a Pediatric Weight Management Program.

Simione M, Wagner S, Kistin CJ, Egan KA, Kelly S, Adams WG, Taveras EM, Hur C.

JAMA Netw Open. 2025 May 1;8(5):e2510087. doi: 10.1001/jamanetworkopen.2025.10087.

PMID: 40366655

2.

Small Intestinal Bacterial Overgrowth and Pediatric Obesity-A Systematic Review.

Koller AM, Săsăran MO, Mărginean CO.

Nutrients. 2025 Apr 29;17(9):1499. doi: 10.3390/nu17091499.

PMID: 40362809 Free PMC article. Review.

3.

The Role of Nutraceuticals and Probiotics in Addition to Lifestyle Intervention in the Management of Childhood Obesity-Part 2: Comorbidities.

Street ME, Casadei F, Di Bari ER, Ferraboschi F, Montani AG, Mele MC, Shulhai AM, Esposito S.

Nutrients. 2025 Apr 28;17(9):1487. doi: 10.3390/nu17091487.

PMID: 40362796 Free PMC article. Review.

4.

Interaction between obesity and asthma in children and adolescents with hypertension based on NHANES 2007-2020.

Ma Y, Wang L, Tao M, Bao Z, Yu R, Liu G, Liu J, Li H.

Front Public Health. 2025 Apr 28;13:1526832. doi: 10.3389/fpubh.2025.1526832. eCollection 2025.

PMID: 40356845 Free PMC article.

5.

Effects of weight status, sex, age, sedentary behavior, pubertal status and socioeconomic status on the physical activity of children and adolescents.

Weimann A, Vogel M, Poulain T, Kiess W.

BMC Public Health. 2025 May 7;25(1):1680. doi: 10.1186/s12889-025-22867-1.

PMID: 40335978 Free PMC article.

6.

Child and Adolescent Health Programs in Obesity and Depression: A Systematic Review and Meta-Analysis.

Sarmiento-Riveros A, Aguilar-Cordero MJ, Barahona-Barahona JA, Galindo GE, Carvallo C, Crespo FA, Burgos H.

Nutrients. 2025 Mar 20;17(6):1088. doi: 10.3390/nu17061088.

PMID: 40292529 Free PMC article. Review.

7.

"It Should Be a Priority": Lessons Learned by Head Start Leaders, Staff, and Parent Facilitators Delivering a Multi-Site Parent-Centered Child Obesity Prevention Intervention.

Gago CM, Aftosmes-Tobio A, Grafft N, Davison KK.

Nutrients. 2025 Mar 18;17(6):1063. doi: 10.3390/nu17061063.

PMID: 40292486 Free PMC article. Clinical Trial.

8.

Comparing Bioelectrical Impedance Analysis, Air Displacement Plethysmography, and Dual-Energy X-Ray Absorptiometry for Body Composition in Pediatric Obesity.

Thajer A, Vasek M, Schneider S, Kautzky-Willer A, Kainberger F, Durstberger S, Kranzl A, Horsak B, Greber-Platzer S.

Nutrients. 2025 Mar 10;17(6):971. doi: 10.3390/nu17060971.

PMID: 40289958 Free PMC article.

9.

Towards a genetic obesity risk score in a single-center study of children and adolescents with obesity.

Partenope C, Monteleone G, Andorno S, Petri A, Prodam F, Bellone S, Mellone S, Giordano M, Rabbone I.

Sci Rep. 2025 Apr 23;15(1):14180. doi: 10.1038/s41598-025-96883-x.

PMID: 40269043 Free PMC article.

10.

Maternal obesity and the incidence of large-for-gestational-age newborns in isolated hypothyroxinemia pregnancies: a comparative cohort study.

Zhang B, Xi S, Zhan Z, Zhang Y, Lu F, Yuan X.

Reprod Biol Endocrinol. 2025 Apr 22;23(1):60. doi: 10.1186/s12958-025-01394-z.

PMID: 40264136 Free PMC article.