Allergy - Specific Reactions

Question 1

What is a True Food Allergy?

Answer 1

IgE Mediated Degranulation of mast cells.

Question 2

What is a False Food Allergy?

Answer 2

Direct stimulation of mast cells or Histamine ingestion.

Question 3

What is Food Intolerance?

Answer 3

Adverse reaction to food with no Histamine-related symptoms.

Question 4

What is Food Sensitivity?

Answer 4

An umbrella term for all reactions to food.

Question 5

What is Food Aversion?

Answer 5

Psychological.

Question 6

What is Cow’s Milk Protein Allergy?

Answer 6

Hypersensitivity to protein in cow’s milk in infants and young kids under the age of 3.

Question 7

Pathophysiology of Cow’s Milk Protein Allergy (2).

Answer 7

1. IgE-Mediated : Rapid reaction within 2 hours of Ingestion.
2. Non-IgE-Mediated : Reactions over several days.

Question 8

Risk Factors of Cow’s Milk Protein Allergy (2).

Answer 8

1. Formula-Fed Babies.

2. Personal/Family History of Atopy.

Question 9

Clinical Presentation of Cow’s Milk Protein Allergy (3).

Answer 9

1. Before Age of 1.
2. GI Symptoms : Bloating, Wind, Abdominal Pain, Diarrhoea, Vomiting.
3. Allergic Symptoms : Hives, Angio-oedema, Cough/Wheeze, Sneezing, Watery Eyes, Eczema.

Question 10

Investigations of Cow’s Milk Protein Allergy (2).

Answer 10

1. History + Examination = Clinical Diagnosis.

2. Skin-Prick Testing - Useful.

Question 11

Management of Cow’s Milk Protein Allergy.

Answer 11

1. Avoid Dairy Products in Breastfeeding Mums.
2. Replace Formula with Special Extensive Hydrolysed Formulas for Cow’s Milk Allergy (or Amino-Acid Formula in Severe).
3. Milk Ladder.
4. Paediatric Referral.

Question 12

What is a Hydrolysed Formula?

Answer 12

Cow’s Milk with broken down proteins so they no longer trigger an immune response.

Question 13

Milk Ladder.

Answer 13

Every 6 months, infants can be tried on malted milk biscuits and then slowly up ladder towards normal diet containing milk.

Question 14

What is Cow’s Milk Intolerance?

Answer 14

Same GI Symptoms as Cow’s Milk Allergy but no Allergic Features.

Question 15

Prognosis of Cow’s Milk Protein Allergy.

Answer 15

Milk tolerance by 5 in IgE-mediated and by 3 in non-IgE mediated reactions.

Question 16

What is Oral Allergy Syndrome/Pollen-Food Allergy?

Answer 16

IgE-mediated hypersensitivity reaction to specific raw, plant-based foods.

Question 17

Why is Oral Allergy Syndrome linked with Pollen Allergies and Seasonal Variation?

Answer 17

Hypersensitivity is initiated by cross-reaction with a non-food allergen, most commonly birch pollen whereby the protein in the food is similar but not identical in structure to the original allergen.

Question 18

Clinical Presentation of Oral Allergy Syndrome.

Answer 18

Mild Tingling/Pruritus of Lips, Mouth and Tongue.