No abstract

Food allergens are frequent causes of anaphylaxis. In particular in children and adolescents they are the most frequent elicitors of severe allergic reactions, and in adults food allergens rank third behind insect venom and drugs. Since July 2006 severe allergic reactions from Germany, Austria, and Switzerland are collected in the anaphylaxis registry. Currently 78 hospitals and private practises are connected. From July 2006 until February 2009 1,156 severe allergic reactions were registered. Among children and adolescents (n = 187, age range from 3 months to 17 years) food allergens were the most frequent triggers, comprising 58% of cases. In the adult group (n = 968, 18 – 85 years) food allergens were in the third position (16.3%) behind insect venom and drugs. In children legumes (31%) and in particular peanuts were frequently responsible food allergens, followed by tree nuts (25%) with hazelnut being the most frequent elicitor. In adults fruits (13.4%) most often induced severe food-dependent anaphylaxis, but also animal products (12.2%); among these most frequently crustaceans and molluscs. Cofactors were often suspected in food-dependent anaphylaxis, namely in 39% of the adult group and in 14% of the pediatric group. In adults drugs (22%) and physical activity (10%) were reported to be the most frequent cofactors, in children physical activity was suspected in 8.7% and drugs in 2.6%. Concomitant diseases like atopic dermatitis, allergic asthma, or allergic rhinoconjunctivitis were reported in 78% of children and adolescents and in 67% of the adults. In conclusion, food-induced anaphylaxis, its cofactors and concomitant diseases are age-dependent. The data offers to identify risk factors of anaphylaxis.

Two sisters (6 and 8 years old) fell ill with coughing, fever and dyspnea after playing in the rotten straw in the barn of their parents' farm. Within 2 weeks symptoms changed to the insidious form of Exogen Allergic Alveolitis. In the broad spectrum of antibodies detected, the Thermophile Actinomycetes were probably the relevant antigens. In spite of efforts to avoid contact with the antigens, there was a relapse of the disease, the most probable sources of the antigens being a mattress in the bed-room and a fodderroom. Since consequent avoidance of antigens is practiced, no signs of relapse have been seen. The other three members of the family were exposed too. The mother and the youngest daughter showed neither symptoms nor specific antibodies. The father turned out to be sensibilitized too. By more attentive self-observation he discovered signs of illness. The distribution of the HLA-markers in the family was not concordant with the pattern of disease nor of antibodies. Some HLA-markers have been described as being associated with Exogen Allergic Alveolitis. Among the markers of our family there are none of these.

No abstract

No abstract