Food Allergy. Againdra K. Bewtra M.B.B.S., M.D. Food Allergy: Outline. Definitions Pathophysiology Signs and Symptoms Food Allergy - Induced Diseases Prevalence and Natural History Diagnosis and Management Prevention. Introduction/Terms.
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Againdra K. Bewtra M.B.B.S., M.D.
Toxic / Pharmacologic
Non-Toxic / Intolerance
B. Immunologic Spectrum
Food Allergy Prevalence
Oral allergy syndrome
25-75% in pollen allergic
37% in children
(rare in adults)
20% in acute
(rare in chronic)
5-6% in asthmatic or food allergic
IgE Non-IgE Acute Chronic
Birch Apple, apricot, carrot, cherry, kiwi, plum
Ragweed Banana, cucumber, melon, watermelon
Grass Cherry, peach, potato, tomato
Prevalence of Allergy to > 1 Food in Family
15% - 40%
* Unless convincing history warrants supervised challenge
Of 32 peanut allergic patients studied by bock et al. Only 8 were successful at peanut avoidance for 5 years.
Peanut allergens on airplanes.
Epi-pen carried at all times
Instructed use in office
Use and go to E.R.
Observe 4 hours
Risk of fatality increases with delay in epinephrine administration
1/3 of pts with fatal or near fatal anaphylaxis had biphasic reactionTreatment
Artificial butter flavor, butter, butter fat, buttermilk, casein, caseinates (sodium, calcium, etc.), cheese, cream, cottage cheese, curds, custard, Half&Half®, hydrolysates (casein, milk, whey), lactalbumin, lactose, milk (derivatives, protein, solids, malted, condensed, evaporated, dry, whole, low-fat, non-fat, skim), nougat, pudding, rennet casein, sour cream, sour cream solids, sour milk solids, whey (delactosed, demineralized, protein concentrate), yogurt. MAY contain milk: brown sugar flavoring, natural flavoring, chocolate, caramel flavoring, high protein flour, margarine, Simplesse®.
Pollutants, Tobacco smoke
Food allergens early
Treatment of peanut allergy with rush I.T. Oppenheimer JJ et al. JACI 1992;90:256-262
Oral allergen gene immunization
Roy et al
Horner et al reported decreased anaphylaxis with DNA vaccine
Generally found not effective
H1 and H2 antihistamines
Oral Cromolyn sodium