Clinical aspects of food allergy

2002 ◽  
Vol 30 (6) ◽  
pp. 901-906 ◽  
Author(s):  
P. S. Papageorgiou
Keyword(s):  
Food Allergy ◽  
Clinical Manifestations ◽  
Food Challenge ◽  
Allergic Patient ◽  
Specific Ige ◽  
Clinical Aspects ◽  
Clinical Syndromes ◽  
Life Threatening ◽  
Definition Of ◽  
Food Allergic Patient

Food allergy affects 2.5% of adults and 6–8% of children, and is a leading cause of life-threatening anaphylactic episodes. Food allergy is defined as an adverse reaction to foods that is mediated immunologically and involves specific IgE or non-IgE mechanisms. In this review only IgE-related food allergy will be considered. Many food allergens are glycoproteins, but they do not share any striking biochemical similarities. The definition of many food proteins at the molecular level has tremendously facilitated our understanding of clinical syndromes and seemingly bizarre observations. Clinical manifestations of food allergy include symptoms of the gastrointestinal, cutaneous and respiratory systems, as well as systemic anaphylaxis. The diagnosis of food allergy involves a stepwise approach, including medical history taking, demonstration of specific IgE and confirmation by oral food challenge. The management of the food-allergic patient at present consists of avoidance of the culprit food and education, while future advances may include specific immunotherapy with modified allergens or DNA vaccination.

Oral food challenges in clinical practice: a missing element of food allergy diagnosis in Russia

2021 ◽  
Vol 17 (4) ◽  
pp. 19-29
Author(s):  
Daria M. Levina ◽  
Ilya A. Korsunskiy ◽  
Daniel B. Munblit
Keyword(s):  
Food Allergy ◽  
Russian Federation ◽  
Food Challenge ◽  
Clinical History ◽  
Allergy Diagnosis ◽  
Laboratory Test Results ◽  
The World ◽  
Life Threatening ◽  
Food Challenges ◽  
Food Allergy Diagnosis

Food allergy is one of the most prevalent allergic conditions, causing reduction in patient quality of life. It is linked with high levels of anxiety due to potential life-threatening reactions, and high economic burden for a healthcare system. Food allergy affects approximately 5 to 10% of children around the world. In Russian Federation the diagnosis of food allergy is primarily based on clinical history, laboratory test results, examination and elimination of suspected food. Meanwhile oral food challenge (OFC) is considered a gold standard of food allergy diagnosis by most of professional bodies nationally and internationally. OFC is a diagnostic procedure involving administration of a causative allergen in gradually increasing amount under a close medical supervision. The method is safe, highly specific and sensitive and is widely used around the world for more than 45 years. The main goals of OFC include food allergy diagnosis and presence of tolerance evaluation, which may result in diet expansion. OFC may also help establishing both, reaction severity and dose needed to elicit reaction, which may further assist with alleviation of patients anxiety. In this paper we discuss existing approaches to the diagnosis of food allergy in Russian Federation and review available recommendations on OFC outlined in international guidelines.

scholarly journals CLINICAL ASPECTS AND ALGORITHMS DIAGNOSTICS OF DIFFERENT TYPES OF ERYTHRODERMA

2018 ◽  
Vol 21 (2) ◽  
pp. 72-80
Author(s):  
O. Yu Olisova ◽  
D. V Zaslavsky ◽  
A. A Sidikov ◽  
I. N Chuprov ◽  
J. Wenzel ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Clinical Aspects ◽  
Inflammatory Dermatosis ◽  
Histological Data ◽  
Definition Of ◽  
A Prospective Study ◽  
Medical University

Erythroderma - the term used for the description intensive and usually widespread reddening of the skin which has arisen owing to activation of the previous inflammatory dermatosis. The aim is to study and compare clinical manifestations of various forms of an erythroderma and also to develop an algorithm of their diagnostics and therapy. We observed 133 patients with an erythroderma undergoing investigation and treatment on bases of dermatologic depatments: V.A. Rakhmanov Clinic of skin and veneral diseases I.M. Sechenov First Moscow State Medical University, Leningrad Regional centre of specialized types of a medical care, Skin-Venerologic Clinic of St. Petersburg and university clinic Bonn the period from 2001 to 2018. A prospective study was conducted at 51 patients, is retrospective - at 82 patients. From them were men - 83 persons and women - 50 people, whose average age was 49 years (in the range 26-85 years). The collecting of the anamnesis is carried out; clinical data are studied and for verification of the diagnosis are compared with results of a histological research. Clinical manifestations of all surveyed groups were similar. The most frequent symptoms were generalized reddening and a peeling of the skin, an itch of skin, different degree of expressiveness and a form of changes of nail plates, changes of palms and soles. Diagnosis on the basis of only clinical examination gave the chance to make the correct diagnosis in 77(58%), in comparison with the final diagnosis 112(84,1%) from 133 made on the basis of set of clinical, histological data and reaction to therapy. In particular, the diagnosis of a psoriatic erythroderma was made in 26(34,58%) from 133, an atopic eythroderma - 20(26,6%), the eythroderma caused by reception of drugs - 24(31,92%), an erythrodermic form of mycosis fungoides/Cezary syndrome - 7(9,31%) from 133 patients. The clinical diagnosis didn’t correspond to the final diagnosis in other 56(42%) from 133 patients. Thus, at diagnosis and definition of forms of an erythroderma important aspect is clinical examination and clinicopathologic correlation.

scholarly journals Pulmonary thromboembolic disease – clinical and etiological aspects in internal medicine department

2015 ◽  
Vol 21 (2) ◽  
pp. 67-74
Author(s):  
Laura Mazilu ◽  
Tatiana Adam ◽  
Andra Suceveanu ◽  
R. Baz ◽  
Doina Tofolean
Keyword(s):  
High Performance ◽  
Clinical Manifestations ◽  
Diagnostic Procedures ◽  
Clinical Aspects ◽  
Pulmonary Infarction ◽  
Ischemic Disease ◽  
Positive Diagnosis ◽  
Clinical Syndromes ◽  
Performance Techniques ◽  
Etiological Spectrum

Abstract Background: Pulmonary embolism (PE) represents the third most frequent vascular disease following acute myocardial ischemic disease and stroke. It is a common and potentially lethal disease. Aim: We observed etiological spectrum, clinical aspects and diagnostic tests for patients with PE. Material and methods: Retrospective observational study that included 53 patients diagnosed with PE between 01.01.2009- 31.12.2013. We followed epidemiological aspects, risk factors, clinical manifestations and methods for positive diagnosis. Results: 53 patients which represents 0.66% from the patients admitted in our department (n=8,011), were diagnosed with PE. The main risk factor for PE was malignancy (n=16). Twenty patients with PE presented deep venous thrombosis (DVT) and 12 patients arterial thrombosis (AT). Main clinical syndromes of patients with PE were pulmonary infarction (n=32), isolated dyspnea (n=11) and circulatory collapse (n=10). A lot of paraclinical investigation sustained positive diagnosis,mainly by high performance techniques. Four cases were diagnosed postmortem. Conclusions: Clinical diagnosis of PE has a low accuracy. Clinical evaluation, even unspecific has a considerable value in the selection of patients who needed further paraclinical diagnostic procedures.

Birch pollen–related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG4 antibodies

2011 ◽  
Vol 127 (3) ◽  
pp. 616-622.e1 ◽  
Author(s):  
Marija Geroldinger-Simic ◽  
Thomas Zelniker ◽  
Werner Aberer ◽  
Christof Ebner ◽  
Cornelia Egger ◽  
...  
Keyword(s):  
Food Allergy ◽  
Birch Pollen ◽  
Specific Ige ◽  
Clinical Aspects

scholarly journals Oral Food Challenge

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 651
Author(s):  
Calvani ◽  
Bianchi ◽  
Reginelli ◽  
Peresso ◽  
Testa
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Pediatric Allergy ◽  
Expert Review ◽  
Ige Mediated ◽  
Food Specific Ige

: Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated food allergy. It is usually conducted to make diagnosis, to monitor for resolution of a food allergy, or to identify the threshold of responsiveness. Clinical history and lab tests have poor diagnostic accuracy and they are not sufficient to make a strict diagnosis of food allergy. Higher concentrations of food-specific IgE or larger allergy prick skin test wheal sizes correlate with an increased likelihood of a reaction upon ingestion. Several cut-off values, to make a diagnosis of some food allergies (e.g., milk, egg, peanut, etc.) without performing an OFC, have been suggested, but their use is still debated. The oral food challenge should be carried out by experienced physicians in a proper environment equipped for emergency, in order to carefully assess symptoms and signs and correctly manage any possible allergic reaction. This review does not intend to analyse comprehensively all the issues related to the diagnosis of food allergies, but to summarize some practical information on the OFC procedure, as reported in a recent issue by The Expert Review of Food Allergy Committee of Italian Society of Pediatric Allergy and Immunology (SIAIP)

scholarly journals Clinical Aspects of Food Allergy in Infants in Pleven Region, Bulgaria

2018 ◽  
Vol 11 (1) ◽  
pp. 36-40
Author(s):  
Vanya M. Nedkova-Milanova ◽  
Tsvetelina V. Miteva ◽  
Darina N. Hristova ◽  
Lyubomira D. Gadjelova ◽  
Magdalena I. Balashkova
Keyword(s):  
Food Allergy ◽  
Immunoglobulin E ◽  
Chronic Diarrhea ◽  
Venous Blood ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Deficiency Anemia ◽  
Clinical Aspects ◽  
The University ◽  
Age Range

Summary Food allergy is an immunoglobulin E-meditated reaction, to which the organism’s immune system reacts to a food allergen, recognizing it as harmful. The study aimed to establish at what age cow’s milk protein allergy is manifested and determine the values of immunoglobulin E (IgE) and hemoglobin(Hb) in children with CMPA in Pleven region, Bulgaria. The study included 94 infants presenting with clinical manifestations of food allergy (age range 0 to 12 months) from Pleven and Pleven region, consulted in 2017 by a pediatrician at the University Hospital Consulting Center in Pleven. Venous blood was collected to determine the IgE and Hb values. Chronic iron-deficiency anemia could be the only clinical manifestation in children with CMPA. Out of all the children with CMPA, 17% had a pronounced anemic syndrome. The rest had normal Hb values. Anemic syndrome could have severe consequences for a growing child. Elevated IgE values were found in 73% of the children tested. CMPA is frequently seen in infants. Early diagnosis of clinical manifestations and diet could prevent severe complications of allergy such as chronic diarrhea, chronic urticaria, and asthma.

scholarly journals Food Allergy: Unproven diagnostics and therapeutics

2020 ◽  
Vol 2 (1) ◽  
pp. 91-94
Author(s):  
Megan F. Patterson ◽  
Stacy L. Dorris
Keyword(s):  
Food Allergy ◽  
Adverse Reactions ◽  
Immunoglobulin E ◽  
Skin Prick Testing ◽  
Scientific Evidence ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Therapeutic Modalities ◽  
Diagnostic Modalities

Food allergy or intolerance is often attributed by patients as the cause of many symptoms unknown to be directly related to food ingestion. For immunoglobulin E (IgE) mediated food allergy, diagnostic modalities are currently limited to the combination of clinical history, evidence of sensitization with food-specific IgE testing and skin-prick testing, and oral food challenge. Many patients find an appeal in the promise of identification of the etiology of their symptoms through alternative food allergy or intolerance diagnostic modalities. These patients may seek guidance from allergists or their general providers as to the legitimacy of these tests or interpretation of results. These tests include food-specific serum IgG or IgG4 testing, flow cytometry to measure the change in leukocyte volume after exposure to food, intradermal or sublingual provocation-neutralization, electrodermal testing, applied kinesiology, hair analysis, and iridology. In addition, there are some unconventional therapeutic modalities for adverse reactions to foods, including rotary diets. None of these have been supported by scientific evidence, and some even carry the risk of severe adverse reactions. It is important that we offer our patients evidence-based, accurate counseling of these unproven modalities by understanding their methods, their paucity of credible scientific support, and their associated risks.

Constitutional Pathology of Erythropoiesis

1952 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Julius Bauer
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Trait ◽  
Chemical Reactivity ◽  
Clinical Manifestations ◽  
Molecular Architecture ◽  
Genetic Types ◽  
Clinical Syndromes ◽  
Special Variety ◽  
Hereditary Defect ◽  
Definition Of

SummaryThe concept and definition of constitutional pathology. Genetic erythropathies such as constitutional spherocytosis, leptocytosis, ovalocytosis and drepanocytosis and their relation to hemolytic clinical syndromes are discussed. Sickle cell trait, sickle cell anemia, and sickle cell disease have to be distinguished as clinical manifestations of drepanocytosis. They represent a special variety of a « status degenerativus » (Bauer). Four genetic types of human hemoglobin have so far been identified that differ from each other by their molecular architecture and chemical reactivity. Several constitutional abnormalities of erythropoiesis other than those just mentioned are discussed: a hereditary defect in hemoglobin synthesis; erythroid multinuclearity; acanthocytosis; Fanconi's syndrome of hypoplasia and abiotrophy of the bone marrow as another variety of a status degenerativus.

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