Figure 1. Convincing, Physician-Diagnosed, and Severe Food Allergy (FA) Categorization Flow Diagram.

Stringent symptoms by organ system include skin or oral mucosa (hives, swelling [except lip or tongue], lip or tongue swelling, difficulty swallowing, throat tightening), respiratory tract (chest tightening, trouble breathing, wheezing), gastrointestinal tract (vomiting), and cardiovascular (chest pain, rapid heartbeat, fainting, low blood pressure). Gastrointestinal symptoms commonly associated with intolerance (eg, diarrhea, cramps) were not considered to be stringent symptoms. The following allergies were considered for exclusion as probable oral allergy syndrome (OAS) based on symptom report: fruit, vegetable, peanut, tree nut, wheat, soy, barley, rice, seed, spice, shellfish, and fin fish.