IGHE and food allergy: Drawing a distinction between primary and secondary food allergy is vital in both risk stratification and management advice1 but may be tricky because patients will often have a mix of both primary food allergy and PFAS to different allergens, whereas others may even demonstrate a pattern of sensitization consistent with primary allergy and PFAS to the same allergen (eg, IgE positivity to both Ara h 2 and Ara h 8 for peanut or Cor a 1 and Cor a 8 for hazelnut).