67-year-old woman • excessive flatulence • persistent heartburn • chronic cough • Dx?

Furthermore, the serum antibody test also identifies allergenic foods whose symptoms have a delayed onset of 4 to 72 hours.⁷ Without this test, those symptoms may be wrongfully attributed to other conditions, and prescribed treatments will not treat the root cause of the reaction.⁸ The information provided in the serum antibody test allows the patient to develop a tailored elimination diet and eliminate causative food(s) faster. Without this test, we may not have identified onions as the allergenic food in our patient.

THE TAKEAWAY

Recent guidelines emphasize that IgG testing plays no role in the diagnosis of food allergies or intolerance.¹ This may indeed be true for the general population, but other studies have shown IgG testing to be of value for specific diagnoses such as migraines or irritable bowel syndrome.^5,6 Given our patient’s unique presentation and lack of response to traditional treatments, IgG testing was warranted. This case demonstrates the importance of IgG food antibody testing as part of a second-tier diagnostic workup when a patient’s gastrointestinal symptoms are not alleviated by traditional interventions.

CORRESPONDENCE
Elizabeth A. Khan, MD, Personalized Longevity Medical Center, 1146 South Cedar Crest Boulevard, Allentown, PA 18103; info@plmc.life.