food allergy
DESCRIPTION
Food Allergy. Dr. Amal Kokandi (MB,BCh, MSc, MD) Assistant professor, Consultant dermatologist April 2010. Good news. - PowerPoint PPT PresentationTRANSCRIPT
Food AllergyDr. Amal Kokandi (MB,BCh, MSc, MD)
Assistant professor, Consultant dermatologistApril 2010
Good newsThe largest observational study so far to
examine the association between chocolate consumption and risk of cardiovascular disease has found that those who ate the most chocolate--around 7.5 g per day--had a 39% lower risk of MI and stroke than individuals who ate almost no chocolate (1.7 g per day). (German Institute of Human Nutrition, Nuthetal, Germany)
Buijsse, B, Weikert C, Drogan D et al. Chocolate consumption in relation to blood pressure and risk of CV disease in German adults. Eur Heart J 2010: DOI:10.1093/eurheartj/ehq068. Available at: http://eurheartj.oxfordjournals.org.
Adverse reactions to food
Adverse reactions to food
Non toxic
Immune mediated
(food allergy)IgE
mediated
Non IgE
mediated
Non-immune mediated
(food intoleran
ce)
Enzymatic
Pharmacological
Others (neurologic & psychologic)
Toxic
IgE mediated food allergyQuick onsetReproducibleTypical symptomsTypical foodsPositive tests
EpidemiologySelf reported ranges from 3-35%Oral food challenges (OFCs) proved ranges
from 1-10-8%More than 20% of adults & children alter
their diet because of perceived belief of averse reaction to food or allergy
SymptomsThe most common food allergy symptoms
include: Tingling in the mouthHives, itching or eczemaSwelling of the lips, face, tongue and throat,
or other parts of the bodyWheezing, nasal congestion or trouble
breathing Abdominal pain, diarrhea, nausea or vomitingDizziness, lightheadedness or fainting
AnaphylaxisConstriction and tightening of airwaysA swollen throat or a lump in your throat that
makes it difficult to breathe Shock, with a severe drop in blood pressureRapid pulseDizziness, lightheadedness or loss of
consciousness
anaphylaxis can cause a coma or death.
Other forms of food allergyExercise-induced food allergy Pollen-food allergy syndrome or oral allergy
syndromeLatex associated food allergy (banana, avocado,
kiwi, papaya and apricot)Note: latex can induce delayed type
hypersensitivityPARTIAL LIST: Band-Aids, rubber bands, erasers, some
shoes and articles of clothing, balloons, surgical gloves, catheters, condoms, some items of sporting equipment , blood pressure cuffs, some watch bands, helmets, tooth brush massagers, bowling balls and ventilator tubing
DiagnosisHistory
+associated conditionsAllergy testing
Skin prick testing (commercial and fresh food)Serum specific IgE
Oral food challenge (open and blinded)
Allergy testingSuspected allergensCommon allergensCommon associations
Egg and peanutMilk and soyPeanut with sesame, tree nuts and lupin
Cross sensitisation and common reactivityNot to miss contaminationDo not test if tolerated
Major allergens (FDA required labeling)Cow’s milkEggWheatPeanut
+Sesame and kiwi
SoyTree nuts (such as
almonds, cashews and walnuts)
Fish (bass, cod and flounder)
Shellfish (crab, lobster and shrimp)
ManagementAllergen avoidance
Consider other allergensDietetic educationSupplementationsFood labellingHidden allergens
ManagementRecognition & treatment of reactions
Education and follow upantihistaminesAdrenaline autoinjectors and labels
Severity of previous reaction, presence of bronchial asthma, peanut allergy
Co morbiditiesFollow up
Problems with avoidanceTotal avoidanceLabelingHidden allergens
Hidden allergensTooth paste
natural fruit extracts such as citrus and strawberriesArachis oil (peanut), coconut, sesame & tree nut oilsWheat, oat, barly
Makeup wheat, sesame oil, soy
Medications, vitamins & supplementsLactose, starch, glucosamine products in shellfish allergies
(made from oyster or other shell fish)Hair products
Wheat, citrus oil, mushroom oil, almond, soy..Adhesives
Wheat (envelope and stamp licking)
Impact of food allergy diagnosisRisk of fatal reactionsQuality of life worse than type I DMRisk of compromised nutrition, dietary advise
is crucial, supplementationShopping and social eventsEconomical problems
Web sites of interestWorld allergy organization site
www.worldallergy.orgFood allergy & anaphylaxix network
www.foodallergy.orgMayo clinic web site
www.mayoclinic.comAbout.com
www.about.com
