April '10 Bulletin
Meeting held: April 26, 2010
Guest speaker: Daniel L. Mayer, M.D.
PAK's Medical Advisor
Adult and Pediatric Allergy,
Asthma & Clinical Immunology
What is an IgE?
IgE is a type of antibody associated with allergies. It packs a powerful punch at triggering an immune response.
What is Anaphylaxis?
A serious allergic reaction that is rapid in onset and may cause death. (FAAN-NIH Conference 2005).
What are some of the causes of severe food allergies?
- hygiene hypothesis - we are too healthy
- genetics - Someone is more likely to develop a food allergy if they have a parent, brother or sister with an allergy of any type
Food Allergy Testing
Prick Skin Tests
- immediate, inexpensive, sensitive method to detect specific IgE
- must be off antihistamines
- IgEs are all over your body not in your blood. This test is more accurate than the blood test. Almost the same as trying the food.
Blood Test ("RAST")
- not affected by antihistamines
- reported in various ways likes "Classes" (which are parameters determined by laboratories not allergists.
- different foods at different ages have different cut-offs.
What is Eczema?
Eczema is usually a medical diagnosis for extremely dry skin. While it affects individuals differently, it can appear as red, dry, itchy patches. Severe eczema can lead to cracked or oozing skin. Atopic eczema, also called atopic dermatitis, is one of the most common and severe. If food is the suspected cause of a child's eczema, the doctor may suggest eliminating the suspected foods from the child's diet to see if symptoms go away.
What if my child has Eczema?
- Skin testing can help confirm that a food allergy is triggering flare-ups.
- If the patient already has a rash, a blood test such as the RAST is used to detect food-specific antibodies in the blood.
Oral Food Challenges
- Food eaten over a period of time increasing amounts supervised by physician with emergency medications available.
- Types of challenges include Open, Single Blind and Double-blind (placebo-controlled)
- Ingestion is the #1 cause of an anaphylactic reaction. However, if a food protein enters your bloodstream (open cut) or mucous membrane (eyes, nose, mouth) through touch, it can lead to a severe allergic reaction.
- Education (preventing a reaction) and being prepared in an emergency are critical
- Medical History is the leading factor in evaluating a case because every child is different.
- Once diagnosed with a severe food allergy, strict avoidance is recommended by the physician.
- Fatal reactions involved no hives or swelling. First sign was respiratory.
- Least food allergy to outgrow is shellfish.
- Child should wear medical jewelry for emergency responders.
- Emergency medication should always be easily accessible. Epinephrine is not a back up to risk-taking.
- Children with food allergies have a higher chance of being diagnosed with a new food allergy.
- Food Label 'may contain' warnings are voluntary. Avoid all foods that have provisional label themes.
- Symptoms: There are two ways your child can have a fatal reaction.
1. drop in blood pressure
2. throat closes up
If your child loses consciousness, raise their legs to increase blood flow to the brain. If they are vomiting and having respiratory problems, turn them to their side to prevent choking. Don't sit them up.
Potential Treatments for Food Allergies
(do NOT try at home!)
Sublingual Therapy (SLIT) - is a form of desensitization that involves the placement of a specified amount of allergy extract under the tongue and holding it there for a few minutes before swallowing it. SLIT is not FDA approved, and is still considered experimental.
Oral Immune Therapy (OIT) - patients are instructed to immediately swallow the allergy extract. The study on desensitizing children with peanut allergies (daily therapy) conducted at Duke University appears to be successful. Click here to learn more.
Chinese Herbal Medicine - Herbal remedies used in Asia for centuries. We are seeing favorable results in early human studies. It must be given on a continuous basis, and there are concerns about its safety and cost. After three years of testing, patients were revisited and sustained their immunity.
PAK is not a professional or medical organization. It is a group of parents sharing information and supporting each other. The discussions, meeting minutes, handouts, guest speakers, agendas, and other products of our support group do not constitute medical/legal advice and should not be relied upon as such. Always discuss individual health questions and medical issues with a qualified personal physician. In regard to Guest Speakers, the purpose of the presentations is to provide a variety of opinions on the spectrum on allergy issues. By no means is PAK adopting the views of its speakers, or endorsing them as medically accepted in the community. It is up to the guests to weigh the persuasiveness and acceptability of the presentations, based on their own knowledge and research.