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Semester 4 - immune system > 3. Food allergy > Flashcards

3. Food allergy Flashcards

1
Q

Why are allergies important?

A
  • are common
  • associated with significant morbidity
  • can be fatal
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2
Q

How common is asthma in children?

A

Diagnosed in >1 in 10 UK schoolchildren

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3
Q

What are the effects of AR on morbidity?

A

Impair sleep and reduce productivity

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4
Q

What isthe effect increased hospital admissions for asthma?

A

Cause high absenteeism

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5
Q

What do restrictive diets in food allergy result in?

A

cause social exclusion and malnutrition

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6
Q

Define allergy.

A
  • “immunological hypersensitivity that can lead to a
  • variety of different diseases via different pathomechanisms
  • with different approaches in diagnosis, therapy and prevention
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7
Q

Define allergen.

A

Any substance stimulating the production of IgE or a cellular immune response. Usually a protein, but can be carbohydrates (much less common).

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8
Q

Define hypersensitivity.

A

Abnormally strong response to a stimulus.

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9
Q

Define sensitisation.

A

Production of IgE antibodies (detected by serum IgE assay or SPT) after repeated exposure to an allergen.

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10
Q

Define atopy.

A

A tendency to produce IgE antibodies in response to ordinary exposure to potential allergens. Strongly associated with asthma, rhinitis, eczema and food allergy.

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11
Q

Define anaphylaxis.

A

A serious allergic reaction with bronchial, laryngeal and cardiovascular involvement that is rapid in onset and can cause death.

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12
Q

What are the major allergic diseases. (8)

A
  • allergic rhinitis
  • allergic conjuctivitis
  • asthma
  • atopic dermatitis (eczema)
  • urticaria
  • insect allergy
  • drug allergy
  • food allergy
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13
Q

What are the features of allergic rhinitis(hay fever)?

A

Blocked/runny nose, itchy nose, sneezing. Triggered by pollen, pets or HDM.

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14
Q

What are the features of allergic conjuctivitis?

A

Red, swollen, itchy, watery eyes. Can occur with allergic rhinitis.

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15
Q

What are the features of asthma?

A

Chest symptoms of wheeze, cough, shortness of breath and tight chest. Not always allergic.

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16
Q

What are the features of atopic dermatitis/eczema?

A

Commonest chronic inflammatory skin disease with itch and excoriation

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17
Q

What are the features of urticaria?

A

Acute/chronic (±6w) maculo-papular pruritic rash without or with angioedema

18
Q

What are the features of insect allergy?

A

Mainly to bee or wasp stings. Mild (local), Moderate (urticaria) Severe (anaphylaxis)

19
Q

What are the features of drug allergy?

A

Especially to antibiotics, but only a minority who are labeled drug allergic are truly allergic.

20
Q

What are the features of food allergy?

A

Clinically broad symptom spectrum varying in timing of presentation and in severity.

21
Q

Which allergic conditions are most common at what age?

A
  • early childhood eczema and food allergies
  • then asthma (peaks at 15)
  • then rhinitis (into 20s)
22
Q

What is the commenest food allergy in infants?

A

Milk - affects 2-3%

23
Q

By what age does milk allergy present?

A

Always by 12 months

24
Q

When might symptoms of milk allergy present after ingestion?

A

When might symptoms of milk allergy present after ingestion?

25
Q

What are the 2 types of presentations of milk allergy?

A
  • Immediate-onset IgE mediated (40%)

* Delayed-onset non-IgE mediated (60%)

26
Q

What is the clinical presentation of IgE mediated milk allergy?

A

Immediate onset:
• Typical allergy symptoms affecting skin, respiratory and GI tracts.
• Symptoms of urticaria, cough, wheeze, vomiting and diarrhoea.
• Can cause anaphylaxis and even be fatal.

27
Q

What is the clinical presentation of non-IgE mediated milk allergy?

A

Delayed onset:
• Predominantly multiple GI symptoms.
• Difficult to diagnose: younger presentation similar to colic, reflux

28
Q

What might a milk allergy be misdiagnosed as?

A

GOR

29
Q

What is GOR and why are neonates more vulnerable?

A

Gastro-oesophageal reflux:

  • horizontal
  • liquid diet
  • oesophagus is short
  • oesophageal sphincter is immature
30
Q

What are the 14 major food allergens?

A
  • celery
  • cereals containing gluten
  • crustaceans
  • eggs
  • fish
  • lupin
  • milk
  • molluscs
  • mustard
  • nuts
  • peanuts
  • sesame seeds
  • soya
  • sulphur dioxide
31
Q

Define food allergy.

A

An adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a food. Definition encompasses immune responses that are IgEmediated or non-IgE mediated.

32
Q

Define food intolerance.

A

Numerous (frequently reported) adverse responses to foods that do not involve an immune response.

33
Q

What are the 2 types of adverse reactions to food?

A
  • non-immune mediated (primary food intolerances)

- immune mediated (food allergy and coeliacs)

34
Q

What is the difference in onset between IgE mediated and non-IgE mediated food allergies?

A
  • IgE: immediate (5-30 mins)

- non-IgE: Delayed (hours-days)

35
Q

What are the common foods that cause IgE food allergies?

A
  • Milk and eggs
  • Peanuts and tree nuts
  • Fish and shellfish
  • Fruit and vegetables (PFS)
36
Q

What are the common foods that cause non-IgE food allergies?

A
  • Milk and soya
  • Wheat
  • Rice, oats (FPIES)
37
Q

What is the difference in presenting age between IgE mediated and non-IgE mediated food allergies?

A

IgE;
• Variable - age of contact
• All milk allergy by 1 year
• PFS in adolescence

Non-IgE:
• Infancy & early childhood
• All milk allergy by 1 year

38
Q

What are the skin presentations of IgE mediated?

A
  • Pruritus, erythema
  • Acute urticaria - localised or generalised
  • Acute angioedema - most commonly of lips, face and around eyes
39
Q

What are the GI presentations of IgE mediated?

A
  • Angioedema of lips, tongue and palate
  • Oral pruritus; nausea, vomiting, diarrhoea
  • Colicky abdominal pain
40
Q

What are the Resp presentations of IgE mediated?

A
  • Upper resp -blocked/runny nose, sneeze, itch
  • Lower resp - wheeze, cough, DIB
  • usually occur with GI symptoms
41
Q

What are the CVS presentations of IgE mediated?

A

Pallor, drowsy, hypotensive

Semester 4 - immune system (6 decks)

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