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At least 19 recordsLinked to original sources
PubMed2002

Beef allergy in children with cow's milk allergy; cow's milk allergy in children with beef allergy.

OBJECTIVE: To review the literature on the prevalence of beef allergy in children allergic to cow's milk and to report a series of patients with beef allergy evaluated for cow's milk allergy. DATA SOURCES: A MEDLINE search for cow's milk allergy and beef allergy was conducted. Also included in this report is a clinical evaluation of both these entities in a population of children with atopic dermatitis. STUDY SELECTION: Data from the literature were summarized. Recruited patients with beef allergy were evaluated on the basis of history, serology, skin prick tests, and double-blind, placebo-controlled food challenge (entry criterion), and presented between 1992 and 2000. RESULTS: In the literature, between 13 and 20% of children with cow's milk allergy also have beef allergy. In our personal series of patients, 28 children (18 boys and 10 girls) diagnosed with beef allergy underwent skin prick tests and double-blind, placebo-controlled food challenge, which showed that 26 (92.9%) were allergic to cow's milk. Two children nonallergic to cow's milk were the only ones who were not sensitized to bovine serum albumin. CONCLUSIONS: Most children with beef allergy are also allergic to cow's milk and should avoid the consumption of dairy products. Sensitization to bovine serum albumin is a marker of cow's milk allergy in children with beef allergy. Elimination of beef from the diet of children with cow's milk allergy should be evaluated on an individual basis after diagnostic workup.

Animals↗
PubMed1987

[Allergy diet: procedures in diagnosis and therapy of food allergy and pseudo-allergy].

Apart from patient history, skin tests and in vitro methods, certain in vivo techniques such as elimination or provocation tests are of great importance in the diagnosis of food allergy. A variety of dietary approaches are used: elimination diets allow the evaluation of clinical improvement after the stepwise removal of suspected foods; on the other hand, provocation diets involve introducing suspected allergenic foods under clinical control. In each individual patient, a specific selection of food provocations is desirable. Food additives are tested according to the schedule of the oral provocation test for idiosyncrasy (OPTI) by the administration of increasing doses in gelatine capsules. In order to rule out psychological influences, blind techniques should be used. For longer periods, three variably intense allergy diets are recommended: Allergy diet 1 ("allergen-free" diet) is used in patients with severe clinical symptoms over a period of up to 2 weeks. Allergy diet 2 (allergen-poor diet) consists of a positively defined mixture of few permitted foods empirically rated as being weak allergens; this diet is suitable as a baseline diet over longer periods of time in patients with marked hypersensitivity reactions. Allergy diet 3 (additive-free diet) distinguishes permitted and prohibited foods. This diet is recommended for patients with pseudo-allergic reactions to additives such as colouring, preservatives or other triggers of pseudo-allergic reactions. In all dietary procedures, the problem of compliance has to be considered, not only with respect to the patient but also with regard to the medical personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergens↗
PubMed1999

Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology.

Adverse drug reactions are a major health problem in the United States. About 25% of all adverse drug reactions have an allergic, pseudoallergic, or idiosyncratic/intolerant basis. Idiosyncratic drug reactions and drug intolerance are also included in this category. Drug allergy may be classified by the Gell and Coombs classification of human hypersensitivity (Type 1: IgE-mediated; Type 2: cytotoxic; Type 3: immune complex; and Type 4: cellular immune mediated). Drug allergy is also frequently characterized by the predominant tissue/organ involved (systemic, cutaneous, or visceral). To some extent, the structural characteristics of drugs and biologic products predict the type of hypersensitivity reaction.

Adverse Drug Reaction Reporting Systems↗
PubMed1998

Identification of HLA-DR and -DQ alleles conferring susceptibility to pollen allergy and pollen associated food allergy.

BACKGROUND: Allergenic crossreactivity of pollen and foods due to the antigeneic similarity of oligopeptides is a well established clinical phenomenon. OBJECTIVE: To determine the immunopathological relevance of antigen presentation, we analysed the HLA class-II genotype of patients with either pollen allergy or pollen associated food allergy. METHODS: One hundred and twenty patients with pollen allergy and 80 patients with pollen associated food allergy were evaluated by skin- prick tests, RAST, and HLA class-II genotyping. The control population comprised 4251 healthy blood and bone marrow donors. RESULTS: Monovalent pollen allergy was observed in 57% (n=68) of patients with pollinosis (57x grass pollen, 11x birch pollen), but only in 15% (n=12) of patients with food allergy (9x grass pollen, 3x birch pollen). Hazelnut (71%), almond (65%), walnut (44%) and apple (41%) were the most common food allergens and frequently associated with birch pollen allergy. Grass pollen allergy was associated with an increased frequency of HLA-DQB1*0301 (RR=2.3; EF=0.4; P=0.0016) when compared with the control population. HLA-DRB *08 conferred a sixfold higher risk for peanut allergy (EF=0.3; P=0.0013) and -DRB1*12 a 13-fold higher risk for carrot allergy (EF=0.3; P<0.000001). The differences on allele frequencies detected among patients with food allergies diminished or turned statistically insignificant when their genotypes were directly compared to those of patients with the corresponding pollen allergies. This was found in the case of birch pollen associated hazel nut allergy for the extended haplotype HLA-DRB1*01, -DQA1*0101, -DQB1*0501 as well as in grass pollen associated peanut allergy for HLA-DRB1*08 (from RR=6, P=0.0013 to insignificant) and in birch pollen associated carrot allergy for HLA-DRB1*12 (from RR=13, P < 0.000001 to insignificant). CONCLUSION: We were able to identify HLA class-II alleles associated with some allergies thus indicating that these alleles might confer susceptibility to the respective allergens. Similarities at the level of the HLA class-II genotype parallel the empirical finding of distinct cross-reactivity patterns thus complementing investigations of IgE specificities. Our observations provide evidence for the major importance of antigen presentation on the manifestation of distinct crossreactivity patterns.

Alleles↗
PubMed2000

Does allergy in parents depend on allergy in their children? Recall bias in parental questioning of atopic diseases. Multicenter Allergy Study Group.

BACKGROUND: A positive atopic family history has proved to be one important risk factor for the development of atopic diseases in offspring. However, many epidemiologists are concerned about the accuracy and reliability of data because responses to questionnaires can be biased for many reasons. OBJECTIVE: The study investigated whether responses of parents questioned about their atopic diseases change depending on the development of atopic symptoms in their children. METHODS: During a prospective birth cohort study on atopy in children (the Multicenter Allergy Study) parents filled out questionnaires twice within 2 years about their atopic diseases. Differences between the 2 responses were examined by log-linear and logistic regression models depending on the diagnosed atopy status of the study children. RESULTS: Mothers tended to report more atopic diseases in the second questioning than in the first, indicating a nondifferential misclassification. Fathers were influenced by the development of atopic diseases in their children: they reported significantly more atopic diseases if the child developed atopic illness with atopic dermatitis. CONCLUSION: In parental questioning about atopic diseases, a recall bias must be considered for the association of atopic family history and atopy in children. Especially in case-control and cross-sectional studies, such misclassifications can result in biased estimates of prognosis and risk factors.

Child, Preschool↗
PubMed1994

Kiwi fruit allergy: a new birch pollen-associated food allergy.

BACKGROUND: To determine the cross-reacting antigens of kiwi fruit and other foods and pollen, we investigated 22 patients allergic to kiwi fruit: 10 with severe systemic reactions and 12 with localized symptoms confined to oral and pharyngeal mucosa (oral allergy syndrome). Seven patients with birch pollen allergy who tolerated kiwi fruit were included as a control group. METHODS: All patients were evaluated by skin testing and RAST; three patients were evaluated by RAST inhibition assays. RESULTS: Prick tests showed positive reactions to kiwi fruit in all patients, whereas specific IgE to kiwi fruit could be demonstrated only in patients with generalized severe symptoms. Surprisingly, all 22 patients with clinical kiwi allergy showed positive prick test results and elevated IgE to birch pollen. Clinically, all complained of rhinitis during birch pollen season. Many patients showed sensitization to grass and mugwort pollen. Also, food allergy was found to be associated with kiwi allergy: we found strong reactions to apple and hazelnut; moderate reactions to carrot, potato, and avocado; and weak reactions to wheat and rye flour, pineapple and papaya, and their enzymes bromelain and papain. RAST inhibition studies revealed cross-reacting antigens between birch pollen and kiwi fruit. Interestingly, patients with birch pollen allergy without clinical signs of kiwi allergy had positive prick test reactions to kiwi. Patients with kiwi allergy showed higher concentrations to birch pollen IgE compared with patients with isolated birch pollen allergy. CONCLUSIONS: Our results indicate that kiwi allergy is a new manifestation of birch pollen-associated food allergy and is mediated by cross-reacting antigens in the kiwi fruit. Kiwi allergy can be expected in patients with birch pollen allergy exhibiting high levels of IgE to birch pollen.

Adolescent↗
PubMedDate not supplied

NHS allergy services in the UK: proposals to improve allergy care.

Allergy is common and its prevalence has increased substantially in the last 2-3 decades. There has been a particular increase in severe allergic disease, including anaphylaxis and food, drug and latex rubber allergy. Provision of allergy services in the NHS is poor and there is a huge unmet need. Allergy is a full specialty, but there are few consultants and few trainees: only six centres in the UK offer a full-time specialist service. Most allergy services are provided by doctors--general practitioners and consultants in other specialties--with little or no training in allergy. Whilst specialists in other areas of medicine have a role in the management of allergy, it is no longer adequate to devolve most allergy care to them. The lack of special care leads to morbidity, mortality and substantial cost to the NHS, much of it avoidable. To ensure that adequate standards of care are satisfactory, allergy care must be led by allergy specialists. More consultant posts and training posts in allergy are urgently needed; this requires recognition by trust managers, regional commissioners and the Department of Health. As a first step, we propose the setting up of appropriately staffed regional allergy centres. This could be achieved with a central directive and (relatively minor) pump-priming of funding.

Allergy and Immunology↗
PubMed1995

Good allergy practice--standards of care for providers and purchasers of allergy services within the National Health Service. Royal College of Physicians and Royal College of Pathologists.

Allergic diseases affect at least 15% of the population and are the cause of much ill-health. 'Clinical immunology and allergy', the term used by the Department of Health in England and Wales for this area of specialization, is recognized as a separate specialty of medicine under the National Health Service. Many organ-based hospital consultants (e.g. chest physicians) have allergy as a special interest or subspecialty. Allergists deal largely with 'itch, sneeze, cough and wheeze' and so are experts in: summer hay fever (seasonal, allergic, conjunctivorhinitis); perennial rhinitis (symptoms of a 'permanent cold'); allergic asthma (including occupational asthma); allergy to stinging insects (especially wasps and bees); allergy to drugs; allergy-related skin disorders, i.e. urticaria, angioedema, atopic eczema and contact dermatitis; food allergy and food intolerance; anaphylaxis (acute generalized allergic reaction); evaluating the role of allergy in non-specific/polysymptomatic illness. Children with allergic disease should be under the overall care of a paediatrician since the progression of allergies in children differs from that in adults. Good allergy practice involves teamwork by doctors, nurses and dietitians. The investigation of allergy patients includes skin tests and challenge procedures (e.g. food allergy tests) as well as various specialized laboratory investigations. Good clinical practice by providers and the effective use of allergy services by purchasers should improve prognosis and cut costs of treatment in allergic disease.

Adult↗
PubMed2000

Costs of beta-lactam allergies: selection and costs of antibiotics for patients with a reported beta-lactam allergy.

OBJECTIVE: To evaluate antibiotic selection and the cost effect of reported beta-lactam allergies. DESIGN: Retrospective medical records review comparing antimicrobial selection and costs in patients with a reported beta-lactam allergy with a group in which no such allergy had been documented. SETTING: University-based family medicine clinic. PATIENTS: Patients who were prescribed at least 1 antibiotic for an upper respiratory tract infection, otitis media, sinusitis, and/or a urinary tract infection were eligible. One thousand two hundred one patients were identified via ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes. Four hundred sixty-five patients were initially identified and an additional 195 family members were eligible for inclusion. MAIN OUTCOME MEASURES: Comparison of antimicrobial selection and costs (by average wholesale price) between patients with and without a reported beta-lactam allergy. RESULTS: Of the 660 patients eligible for inclusion, 99 (15%) had a documented beta-lactam allergy. Of the patients with a documented allergy, only 33% had a description of their purported reaction. The mean antibiotic cost for patients with a beta-lactam allergy was significantly higher compared with those without a beta-lactam allergy ($26.81 vs $16.28, respectively; P =.004). Patients with a beta-lactam allergy were more likely to have received a cephalosporin, macrolide, or a miscellaneous agent (eg, quinolone, tetracycline, or nitrofurantoin) (P =.001). CONCLUSIONS: Patients with a beta-lactam allergy had higher antibiotic costs and were more likely to receive a broader-spectrum antibiotic. Most patients with a reported allergy did not have a description of their reaction. Skin testing may be of use in detecting true beta-lactam allergies; however, further study is needed to determine its cost-effectiveness.

Adolescent↗
PubMed1996

Cat and dog allergy and total IgE as risk factors of laboratory animal allergy.

BACKGROUND: Laboratory animal workers are at high risk of developing occupational allergy. In many cases the severity of allergy symptoms makes further work with laboratory animals impossible. OBJECTIVE: This study was designed to estimate prevalence rates of sensitization and symptoms of allergy in a population of laboratory animal workers and to determine the association between various host factors and these prevalence rates. METHODS: A cross-sectional survey was undertaken in 540 workers at eight facilities in the Netherlands. All participants completed a questionnaire and underwent skin prick testing with common and occupational allergens. In addition, total and specific IgE measurements were obtained. RESULTS: Prevalence rates of allergy symptoms caused by working with rats and mice were 19% and 10%, respectively. Symptoms, especially chest tightness, were strongly related to sensitization. Rat and mouse allergy, defined as symptoms of allergy accompanied by specific atopic sensitization, were highly associated with elevated total IgE, reported adverse reactions, and positive skin prick test responses to common allergens. This relationship could be explained by a response to cat or dog allergens. CONCLUSIONS: Allergy to cats or dogs seemed to be an important risk factor for laboratory animal allergy, whereas allergy to pollen or house dust mite, in the absence of cat and dog allergy, appeared to be insignificant. More conclusive evidence about cat and dog allergy preceding laboratory animal allergy can only be provided after analysis of follow-up data.

Allergens↗
PubMed1992

Allergy. Conventional and alternative concepts. A report of the Royal College of Physicians Committee on Clinical Immunology and Allergy.

Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are due entirely to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may have either a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time. The most common allergens (substances causing allergy) are grass and tree pollens, the house dust mite, products from pets and other animals, agents encountered in industry, wasp and bee venom, drugs, and certain foods. Food allergy presents a particularly difficult problem. Some individuals who react to food suffer from food allergy in its strict sense but in others there is no evidence of an alteration in the immune system. Here the term 'food intolerance' is preferable. Conventional doctors treat allergy by allergen avoidance--where this is possible--and drugs that relieve symptoms. In a few selected cases, in which other methods have failed, immunotherapy (desensitisation or hyposensitisation) is recommended. Although patients who consult practitioners of alternative allergy may do so by preference, it is often also because they are dissatisfied with the conventional approach to diagnosis and treatment, or because they have conditions which conventional doctors do not accept as having an allergic basis. There is a very wide range of alternative approaches to allergy, including the methods used by clinical ecologists and other treatments such as acupuncture and homoeopathy. Hypnosis may have a small role to play in helping the asthmatic and similar effects have been suggested for acupuncture. Furthermore, it is likely that there are still many active ingredients in medicinal plants used by herbalists but these need to be clearly identified and purified before their usefulness can be evaluated properly. Apart from these situations, we have yet to be convinced by substantial evidence that any of the other alternative methods of diagnosing or treating allergic disease are of proven value. There have, however, been many false and misleading claims and serious harm may be caused by misdiagnosis or delays in appropriate treatment. The public should be warned against costly methods of diagnosis and treatment which have not been validated.(ABSTRACT TRUNCATED AT 400 WORDS)

Allergens↗
PubMedDate not supplied

[Prevalence of soya allergy in children with cow's milk allergy].

UNLABELLED: Because of contradictory data about the prevalence of soya allergy in children recommendations for the use of the protein-based formulas are ambiguous. THE AIM of the study was to estimate the prevalence of soya allergy in children with IgE-associated cow's milk allergy. MATERIAL: Ninety seven patients aged from six months to four years with personal history suggestive of food allergy with specific IgE to cow's milk protein attending the Department of Pediatrics, Allergology and Gastroenterology between 2000-2002 were studied. In all patients specific IgE to soya protein were detected. RESULTS: In 45% children with IgE-associated cow's milk allergy specific IgE to soya protein were detected. Clinical manifestation in both groups of children with or without specific IgE to soya protein was similar. Gastrointestinal tract symptoms were observed more often in children with cow's milk and soya allergy than in children with cow's milk allergy (52 and 42% respectively) and atopic dermatitis was observed more often in children with cow's milk allergy than in children with cow's milk and soya allergy (81 and 74% respectively). The incidence of respiratory tract symptoms in both groups of children was similar. The differences were not statistically significant. CONCLUSION: It seems, that hydrolyzed formulas should be the preferred choice for children because of a high prevalence of soya protein allergy in children with IgE- associated cow's milk allergy.

Animals↗
PubMed1992

Allergy: conventional and alternative concepts. Summary of a report of the Royal College of Physicians Committee on Clinical Immunology and Allergy.

Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are entirely due to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may either have a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time. The most common allergens (substances causing allergy) are grass and tree pollens, the house dust mite, products from pets and other animals, agents encountered in industry, wasp and bee venom, drugs, and certain foods. Food allergy presents a particularly difficult problem. Some individuals who react to food suffer from true food allergy but in others there is no evidence of an alteration in the immune system. Here the term 'food intolerance' is preferable. Conventional doctors treat allergy by allergen avoidance--where this is possible--and drugs that relieve symptoms. In a few selected cases, in which other methods have failed, immunotherapy (desensitisation or hyposensitisation) is recommended. Patients who consult practitioners of alternative allergy often do so because they are dissatisfied with the conventional approach to diagnosis and treatment, and sometimes because they have conditions which conventional doctors do not accept as having an allergic basis. There is a very wide range of alternative approaches to allergy, including the methods used by clinical ecologists, acupuncturists and homoeopathists. Hypnosis may have a small role to play in asthma, and similar claims for acupuncture need to be evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)

Asthma↗
PubMed2002

Prevalence of food allergies in young adults and their relationship to asthma, nasal allergies, and eczema.

BACKGROUND: The true prevalence of food allergy in adults is generally thought to be uncommon. It is unknown whether there are any relationships between food allergy and atopic diseases. OBJECTIVE: To determine the prevalence of probable immunoglobulin (Ig)E-mediated food allergy to peanut, shrimp, cow's milk, wheat, and egg as defined by a positive skin prick test result and relevant clinical history to the same food, and to explore the relationship with atopic diseases. METHODS: Cross-sectional epidemiologic study. One thousand one hundred forty-one randomly selected young adults (aged 20 to 45 years) underwent skin prick testing to five common food allergens (cow's milk, peanut, egg white, shrimp, and wheat), completed a detailed questionnaire, including validated items on respiratory symptoms, history of asthma and other allergic conditions, as well as undergoing lung function testing. RESULTS: Just over one percent (1.3%, n = 15) had probable IgE-mediated food allergy. The prevalence of probable IgE food allergy was: <0.27% for wheat, 0.09% (95% confidence interval = 0.0 to 0.49%) each for cow's milk and egg, 0.53% (0.21 to 1.09%) for shrimp, and 0.61% (0.25 to 1.26%) for peanut. Those with probable IgE peanut and shrimp allergy were significantly more likely to have current asthma and doctor-diagnosed asthma. Wheeze and history of eczema were also associated with peanut allergy, whereas nasal allergies were associated with shrimp allergy. CONCLUSIONS: The prevalence of probable IgE-mediated food reactions is rare in young adults. Some positive associations between probable IgE-mediated food allergy and allergic diseases were found, but larger study numbers are required to confirm these results.

Adult↗
PubMed1999

Perceived prevalence of peanut allergy in Great Britain and its association with other atopic conditions and with peanut allergy in other household members.

BACKGROUND: Despite increasing awareness of peanut allergy, little is known of its prevalence. We report on a two-stage interview survey conducted in Great Britain. METHODS: A total of 16434 adults (aged 15+ years) reported their own allergies and atopies and named cohabitants with peanut allergy (stage 1). Follow-up interviews were conducted with identified sufferers from peanut allergy (stage 2). RESULTS: At stage 1, peanut allergy was reported in 58 respondents and 205 other household members. When we accounted for cases where peanut allergy was unconfirmed or newly reported at stage 2, the prevalence, based on 124 confirmed sufferers, was estimated as 0.48% (95% confidence interval 0.40%-0.55%). The prevalence in children (0.61%, 0.41%-0.82%) was slightly higher than in adults; age-of-onset was strikingly earlier. Prevalence was strongly associated with other atopies, particularly tree-nut allergy. Cases tended significantly to cluster in households. Half of cases had never consulted a doctor. Exactly 7.4% reported being hospitalized after a reaction. CONCLUSIONS: Peanut allergy is reported by 1 in 200 of the population and is commoner in those reporting other atopies. The fact of similar rates in children and adults argues against a recent marked rise in prevalence. The frequency and potential lethality of this disorder emphasize the need for sufferers to demographic factors, other food allergies, atopic conditions, and allergy in family/household members. Our study comprised a screening survey and detailed interviews with sufferers identified. The frequency and potential lethality of this disorder emphasize the need for sufferers to receive correct medical advice on management [corrected].

Adolescent↗