ALLERGOLOGY Removals Review by Alec Maquiling: Aureus, E. Coli, C. Difficile), Toxins (Scombroid
ALLERGOLOGY Removals Review by Alec Maquiling: Aureus, E. Coli, C. Difficile), Toxins (Scombroid
ALLERGOLOGY Removals Review by Alec Maquiling: Aureus, E. Coli, C. Difficile), Toxins (Scombroid
OUTLINE I. Adverse Food Reactions II. Anaphylaxis III. Urticaria and Angioedema C4. Cross-reactivity: when an antibody reacts not only with the original allergen but also with a similar allergen -NOTE: LATEX cross reacts with banana, avocado, kiwi, and chestnuts C5. Correlation with other diseases - FA coexists with asthma, atopic dermatitis, eosinophilic esophagitis, and exercise-induced anaphylaxis -Coexistence of FA and ASTHMA is a risk factor for asthma exacerbations - Exercise-induced anaphylaxis: it happens when you eat a certain food (most common triggers: shellfish, alcohol, tomatoes, cheese, celery), then you exercise. The food triggers mentioned can be eaten WITHOUT symptoms in the absence of exercise. - 75% of patients who experience this are females! C6. Natural History of Food Allergy - Most FA will tolerate milk, egg, soy and wheat (but time course varies and may occur as late as teenage years) - A higher initial level of serum IgE against a certain food is associated with a lower rate of resolution C7. Types of Food Allergy (REMEMBER THIS) C7.1 IgE-MEDIATED FOOD ALLERGY C7.1.1 Clinical Features: -RAPID onset (within 1-2 hours) -Resolve quickly (within minutes to few hours) -Several symptoms involved: MOST COMMONLY INVOLVED: SKIN, 2nd most commonly involved: Gastrointestinal C7.1.2 Examples Allergy of IgE-Mediated Food
I. ADVERSE FOOD REACTIONS Definition: ANY reaction following the ingestion of a food. A. ORAL FOOD TOLERANCE: suppression of adverse immune responses to nonharmful food antigens. A1. Mechanisms: 1. Mucosal Barrier (Intestinal Intraepithelial cells, secretory IgA, Regulatory T cells, Commensal Flora) 2. Balance of Th1 and Th2 cells B. FOOD INTOLERANCE: adverse WITHOUT a clear immune mechanism event
B1. HOST factors: enzyme deficiencies, GI disorders, idiosyncratic reaction, psychologic, migraines B2. FOOD factors: infectious organisms (S. aureus, E. coli, C. difficile), toxins (scombroid poisoning [histamine]), pharmacologic agents, contaminants C. FOOD ALLERGY (FA): a reaction WITH an immune mechanism C1. Prevalence - 2.5% of newborn infants have hypersensitivity to COW MILK in the FIRST year of life. -About 1.5% of young children are allergic to EGGS. C2. Common food allergens (in the Philippines) - Seafood, fish, eff, milk, soy, peanuts (Note: Chicken allergy is NOT common) - PEANUT allergy: most common cause of anaphylaxis in children leading to an ER consultation. - REMEMBER: PROTEIN component is responsible for causing food allergy C3. Genetics (chance of getting food allergy) - If both parents both have food allergy: 50-80% - If both parents are atopic: 40-60% - If one of the parents have food allergy: 40% - If neither parent has food allergy: 15%
1. Oral Allergy Syndrome -aka POLLEN-associated FA syndrome (because it also commonly affects those who are allergic to pollens) -allergy usually to RAW fruits and vegetables - confined to LIPS, MOUTH, THROAT 2. Acute Urticaria - rapid onset after ingestion of food characterized by round or irregular shaped PRURITIC WHEALS