Food Allergy (Allergies and Infectious Diseases)

95 Pages·2010·0.98 MB·English

by  Alexander K. c. Leung

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 [phone]; Fax [phone]
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