DBPCFC is the gold standard for diagnosing AFR and is usually performed by an allergist/immunologist familiar with the management of anaphylaxis. A positive challenge does not necessarily identify the mechanism of the reaction (IgE-, non-IgE-, or non-immune-mediated reaction). Food challenges are contraindicated In suspected food-Induced anaphylaxis. Good history and consistent SPT are usually sufficient to establish a diagnosis without a food challenge. With vague history and inconclusive SPT, an open challenge may be indicated, followed, if positive, by a blinded challenge. Details of food-challenge techniques are available in standard allergy textbooks
