The recently revised nomenclature for allergic diseases includes several manifestations of food allergy such as asthma, urticaria and/or angioedema, anaphylaxis, eczema, and rhinitis. The aim of a correct diagnosis of food allergy is to establish a causal relationship between food ingestion and the clinical symptoms reported by the patient and to identify the triggering allergen and the immune mechanism determining the reaction. The current approach to food allergy diagnosis using well-established tools including medical history, skin test (ST), immunoglobulin E (IgE) detection, and oral challenge, sich as double-blind placebocontrolled food challenge (DBPCFC) is depicted. The use of flow cytometry has increased the use of basophil activation testing to confirm the diagnosis of food allergy. Allergenic molecules can be used as the most objective tool for the best diagnosis and unequivocal identification of affected subjects molecules can be used as the most objective tool for the best diagnosis and unequivocal identification of affected subjects. A combination of in vivo and in vitro tools are needed to reach a good level of diagnostic reliability in food allergy diseases. Great expectations arise from the combined use of allergens obtained by molecular biology techniques, exactly as they are seen and processed by the immune system, sophisticated assays that allow suitable multiple-IgE detection of hundreds of allergenic molecules and global sharing of a huge mass of data. This novel approach will represent developments that are not too far in the future for food allergy diseases.
