Adverse Food Reactions Flashcards
3 key questions
what happened?
what food?
how much food?
IgE-med disorders
onset
common systems
rapid, usually during feeding, within 1-2 hrs
1 skin
2 GIT
respiratory less common
non-IgE med
onset
system
hours to days
GI
greatest foreign antigenic load
food allergens
substance responsible for allergy
proteins
*alpha-gal - red meat
top allergens (8, in order)
milk egg soy fish shellfish peanut wheat rice :(
class i vs class ii food allergen
sensitization occurs where
stability
i - sensitization at GIT; stable to heat, acid, proteases
ii - sensitization in resp tract or skin; heat-labile, susceptible to enzymatic degradation
class i food allergen (primary sensitizers)
MW
oks na ‘to if ok naman pagkaluto
*water-soluble
10-70kD
false
*ex. cow milk - caseins, albumin chicken egg peanut - glycinin, vicillin soybean - trypsin inhibitor shrimp - tropomyosin fish - paralbumin lipid transfer proteins - apple apricot peach plum corn
class ii food allergen (cross-reactive)
generally what material
usually what
skin test?
plant-derived
fresh food
none, cos difficult to isolate
clinical consequence of unnecessary modification of diet
vit and min deficiency, malnutrition
skin prick test:
when to observe
when positive
pos/neg predictive value
15 mins
3mm > (-)
<50%
>95%
- sensitivity 90
- specificity 50
inter test comparison (spt vs serum food ige test)
spt +
ige +++
tests are designed for screening t/f
false. skin tests are diagnostic aids
food vs aeroallergens: predictive value whatever
for aeroallergens, positive results are more predictive!
peanut epitopes implicated in allergy (3)
ara h1 vicillin
ara h2 conglutin
ara h3 glycinin
uses allergenic ptns derived from recombinant dna tech or purification from natural sources; can ID specific IgE reactivity to recombinant allergenic ptns rather than whole antigen
component-resolved diagnosis (crd)
goat milk is a good alternative for cow’s milk t/f
false, mare’s milk is better? hehe only 5% cross reactivity.
most beans also have a low reaction rate, with peanuts
when to consider that child is allergic and will not undergo food challenge
<2y/o, >2/yo
cow’s milk
egg
peanut
use 100% diagnostic spt cut off values…. ???? what it mean
cow milk >=6, >=8
egg >=5, >=7
peanut >=4, >=8
expensive and slightly less negative test than SPT, but can be used as a basis to avoid oral challenge, predict prognosis and time interval to do oral challenge if FA is outgrown
FEIA fluorescence enzyme immunoassay
peanut 14 kU/L
fish 20 kU/L
food challenges can be used in non-ige FA
true. may be used in both ige and non-ige
gold standard food challenge
DBCFC double blind placebo controlled food challenge
when to consider ofc (3)
ambiguity in hx and testing
further clarity
possible outgrown allergy
FA management (4)
APIE
avoidance
plan for accidental exposure
insurance of sufficient diet
educate (allergens in other food; read label, how to use epinephrine, which best treated with AH)
immunotherapy for FA!
NOT RECOMMENDED
