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Food Allergy (Allergies and Infectious Diseases) PDF

95 Pages·2010·0.98 MB·English
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ALLERGIES AND INFECTIOUS DISEASES FOOD ALLERGY No part of this digital document may be reproduced, stored in a retrieval system or transmitted in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services. A LLERGIES AND I D NFECTIOUS ISEASES Additional books in this series can be found on Nova’s website under the Series tab. Additional E-books in this series can be found on Nova’s website under the E-books tab. F B OOD AND EVERAGE CONSUMPTION AND HEALTH Additional books in this series can be found on Nova’s website under the Series tab. Additional E-books in this series can be found on Nova’s website under the E-books tab. ALLERGIES AND INFECTIOUS DISEASES FOOD ALLERGY ALEXANDER K. C. LEUNG AND JAMES S. C. LEUNG Novinka Nova Science Publishers, Inc. New York Copyright © 2010 by Nova Science Publishers, Inc. All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS. LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Available upon Request ISBN: 978-1-61761-239-8 (eBook) Published by Nova Science Publishers, Inc.  New York CONTENTS Preface vii Author’s Contact Information ix Chapter 1 Introduction 1 Chapter 2 Epidemiology 3 Chapter 3 Pathogenesis 5 Chapter 4 Clinical Manifestations 7 Chapter 5 Clinical Evaluation and Diagnostic Studies 31 Chapter 6 Management 35 Chapter 7 Future Therapeutic Options 47 Chapter 8 Vaccinations and Food Allergies 51 Chapter 9 Conclusion 53 References 55 Index 77 PREFACE Food allergy is an adverse reaction resulting from an inappropriate immunological response to a food antigen. It usually presents as multi-system involvement. Gastrointestinal symptoms, cutaneous symptoms, and respiratory symptoms occur in 50 to 80%, 20 to 40%, and 4 to 25% of cases, respectively. Gastrointestinal manifestations include oral allergy syndrome, gastrointestinal anaphylaxis, allergic eosinophilic esophagitis, allergic eosinophilic gastro- enteropathy, food protein-induced enteropathy, food protein-induced entero- colitis syndrome, food protein-induced proctocolitis, gluten-sensitive enteropathy, infantile colic, irritable bowel syndrome, and constipation. Cutaneous manifestations are urticaria/angioedema, atopic dermatitis, contact dermatitis, and dermatitis herpetiformis. Finally, rhinitis/rhinoconjunctivitis, asthma, Heiner syndrome, and serous otitis media are the respiratory manifestations of food allergy. Other manifestations include systemic ana- phylaxis, food-dependent exercise-induced anaphylaxis, migraine, epilepsy, diabetes mellitus, nephrotic syndrome, nocturnal enuresis, anemia, thrombo- cytopenia, vasculitis, and arthropathy/arthritis. Skin-prick testing with food extracts is often used to screen patients with suspected IgE-mediated food allergies. Simultaneously, since many children with IgE-mediated food allergies have elevated serum IgE levels, serum IgE antibodies specific for allergens can be measured in vitro by RAST, ELISA, or FEIA techniques. However, the double-blind placebo-controlled food challenge is objective and is considered the “gold standard” for the diagnosis of a food allergy. Nonetheless, an open or single-blind food challenge is acceptable when the resulting symptoms can be objectively observed. Definitive treatment of food allergy is strict elimination of the offending food from the diet. Symptomatic reactivity to food allergens is generally very viii Alexander K. C. Leung and James S. C. Leung specific, and patients rarely react to more than one food in a botanical or animal species. If elimination diets are prescribed, care must be taken to ensure that they are palatable and nutritionally adequate. Patients must have a good knowledge of foods containing the allergen and must be taught to scrutinize the labels of all packaged food carefully. Emergency treatment of food-induced anaphylaxis centers on basic life support principles, and intramuscular injection of epinephrine. A fast-acting H antihistamine should 1 be considered for the child with progressive or generalized urticaria or disturbing pruritus. Pharmacological therapies such as mast cell stabilizers have little role in the treatment of food allergy. AUTHOR’S CONTACT INFORMATION Alexander K. C. Leung MBBS, FRCPC, FRCP(UK & Irel), FRCPCH, FAAP; Clinical Professor of Pediatrics; The University of Calgary; Pediatric Consultant; Alberta Children’s Hospital James S. C. Leung MD; Pediatric Resident; Hospital for Sick Children; The University of Toronto

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