Provocation tests (food, drugs)

Oral provocation test/Food challenge test

Food provocation test distinguishes food sensitization from clinically significant allergy which, ultimately, frees the patient from unnecessary elimination diets that impair quality of life and can cause malnutrition.

Patients receive a suspected allergen from food in titrated amounts and at certain time intervals. The oral challenge test begins with a dose that does not elicit a reaction in most patients and is continued with gradually increasing amounts of food, usually in a time interval of 15-30 min until the full dose is reached or until the first symptoms of the reaction appear.

There is a risk of an allergic reaction to food that can be manifested by urticaria, angioedema, worsening of atopic dermatitis, rhinorrhea, bronchospasm, gastrointestinal symptoms (cramps, vomiting, diarrhea) and, ultimately, life-threatening anaphylaxis. There is no alternative procedure because a provocative experiment is the gold standard in the diagnosis of food allergy.

Drug Provocation test

Drug provocation test is often needed when evaluating patients with suspected drug hypersensitivity reactions. A provocative trial is the only diagnostic procedure that reliably excludes or proves hypersensitivity to the incriminated drug.

Patients receive the suspected drug in titrated amounts and at specific time intervals. The experiment is started with a low dose of the drug which is gradually increased, in a time interval of 45-60 min, until the full therapeutic dose is reached or until the first symptoms of an allergic reaction appear. There is a risk of hypersensitivity reactions that may be manifested by urticaria, angioedema, rhinorrhea, bronchospasm, gastrointestinal symptoms (cramps, vomiting, diarrhea), rash, joint swelling, but also life-threatening reactions such as anaphylaxis, toxic epidermal necrolysis, Steve Johnson’s syndrome and DRESS – drug rash with eosinophilia and systemic symptoms.

There is no alternative procedure because drug provocation testing is the gold standard in the diagnosis of drug hypersensitivity, but there is the possibility of using another alternative drug.