The Natural History of Food Allergy

Wood, Robert A.

doi:10.1002/9781444300062.ch37

Cited by 67 publications

(86 citation statements)

References 3 publications

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“…This is also concordant with food allergy being the most prevalent in young children and food being the most frequent trigger of anaphylaxis in children [15,17,21,31]. The latter might also explain the gradually lowering figures in subsequent age classes in our patient group.…”

Section: Discussionsupporting

confidence: 86%

“…In contrast to the findings of an Italian survey [21], in our survey only two cases were triggered by fish/shellfish. This distribution of food triggers might reflect different eating habits in different countries [25,31]. In contrast to other surveys [17,21], there were no cases triggered by immunotherapy, although immunotherapy currently is prescribed at PedAllUH as well as at PedAllPM and PedPH.…”

Section: Discussioncontrasting

confidence: 70%

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Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach

et al. 2008

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Anaphylaxis remains under-diagnosed and under-treated. A better knowledge of patterns and triggers of anaphylaxis might contribute to a better management. In this study we evaluated the demographic and clinical features of anaphylaxis in pediatric patients, as well as its triggers and therapeutic approach. From May 1st 2004 until April 30th 2006 we prospectively collected data on all patients referred for investigation of anaphylaxis to the pediatric department of the University Hospital Gasthuisberg Leuven and to two private pediatric practices. Data were stored in a MYSQL database by use of an online encrypted web form. Sixty-four cases of anaphylaxis occurred in 48 children, aged 6 months to 14.8 years. Twenty-seven episodes (42.2%) occurred at home. The symptoms were dermatologic in 62 (96.9%) episodes, respiratory in 57 (89.1%), gastrointestinal in 19 (29.7%), cardiovascular in 14 (21.8%), and neurological or behavioural in 19 (29.7%). Antihistamines were administered in 41/57 (71.9%) cases, corticosteroids in 26/57 (45.6%), beta-2-mimetics in 14/57 (24.6%), and adrenaline in 11/57 (19.3%). Out of nine cases where Epipen was available at the moment of anaphylaxis, it was administered in one case only. Food was the cause of anaphylaxis in 42/55 (76.4%) cases with identified trigger, while medication, insect stings, latex, and birch pollen triggered 5 (9.1%), 4 (7.3%), 3 (5.5%), and 1 (1.8%) case(s), respectively. Allergy to the trigger was known prior to anaphylaxis in 19/55 (34.5%) cases. In conclusion, anaphylaxis in pediatric patients generally presents with dermatologic and respiratory symptoms, while in 1/5 episodes cardiovascular symptoms occur. Food is by far the most frequent trigger. Allergy to the trigger is known in 1/3 cases only. Anaphylaxis is under-treated, even when appropriate medication is available.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 70%

Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach

et al. 2008

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“…The prevalence of food allergy peaks at about 6% to 8% at 1 year of age, and then falls progressively until late childhood when it decreases to 2% to 4% and remains stable [8]. In addition, the persistence of specific food allergies is variable.…”

Section: Unique Psychological Challenges Of Food Allergymentioning

confidence: 98%

“…Initial symptoms can be vague and ambiguous, and caregivers are often uncertain about the meaning of their infant's skin rashes or vomiting. Thus, suspected food allergy is relatively common in early childhood, with one fourth of parents reporting adverse reactions to foods in their infants; in contrast, true IgE-mediated food allergy is confirmed in 5% to 10% of infants [5,8]. Parents may respond to ambiguous symptoms by implementing restrictive diets on their own, potentially putting children at risk for nutritional deficits and malnutrition [9,10].…”

Section: Unique Psychological Challenges Of Food Allergymentioning

confidence: 99%

Addressing the psychological needs of families of food-allergic children

Klinnert

Robinson²

2008

Curr Allergy Asthma Rep

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The increase in food allergies among US children has led to greater awareness of the psychological impact on their families. A variety of negative effects can result from both the daily strain of food-allergy management and the constant vigilance and fear that this condition engenders. Most of these effects are normal and expected responses to having a child with a demanding condition filled with uncertainties. However, a small but substantial proportion of families living with childhood food allergy experience significant psychological distress and/or maladaptive coping responses that interfere with the child's psychological and social development and family members' optimal functioning. Health care providers must be aware of the psychological challenges these families face, understand their role in helping families to achieve positive adaptation, and know when to encourage families to seek psychoeducational guidance.

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“…Prospectively collected data on the natural history of egg allergy are limited [91]. A retrospective study found that of 25 young children with challenge-proven egg allergy, 11 (44%) developed tolerance within 2.5 years [92].…”

Section: Prognosis and Natural Historymentioning

confidence: 99%

The diagnosis and management of egg allergy

Heine

Laske²,

Hill³

2006

Curr Allergy Asthma Rep

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Egg allergy is a common food hypersensitivity in children. Atopic dermatitis represents the main clinical manifestation in infancy. On first exposure, many of these infants present with urticaria, angioedema, or anaphylaxis. The role of egg allergy in gastrointestinal conditions is less well understood. The "gold standard" for the diagnosis of egg allergy is the double-blind, placebo-controlled food challenge. Diagnostic cut-off levels have been defined for food-specific serum immunoglobulin E antibody level and skin prick test wheal diameter that predict an adverse challenge outcome. This has significantly reduced the need for formal food challenges. Atopy patch testing, in conjunction with immunoglobulin E-based tests, may further improve the accuracy of predicting a positive challenge. The treatment of egg allergy consists of dietary elimination, or a maternal elimination diet in breast-fed infants. Approximately two thirds of infants with egg allergy will become tolerant by 7 years of age.

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The Natural History of Food Allergy

Cited by 67 publications

References 3 publications

Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach

Anaphylaxis in referred pediatric patients: demographic and clinical features, triggers, and therapeutic approach

Addressing the psychological needs of families of food-allergic children

The diagnosis and management of egg allergy

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