Food Allergy Flashcards
Define allergy
Define allergen
Immunological hypersensitivity which can lead to a number of different disease via different pathomechanisms with different approaches in diagnosis, therapy and prevention.
Substance that leads to IgE production or a cellular immune response - usually a protein but can also be a carbohydrate
Name 2 ways in which sensitisation can be spotted in an individual
Serum IgE assay
Skin prick test
Give four conditions associated with atopy.
Allergic rhinitis
Asthma
Eczema
Food allergy
Give two differentials for delayed onset non-IgE mediated milk allergy.
What is the difference between IgE mediated and non-IgE mediated food allergy?
Which is more common?
Give an example of a non-IgE mediated food allergy.
Colic
Reflux
IgE mediated - urticaria, cough, wheezing - immediate onset
Non-IgE mediated - GI symptoms mainly + perianal redness + pillow and tiredness - multiple - delayed onset
Delayed onset = more common (60%)
Coeliac disease
When does PFS present?
Typical features?
What is it associated with?
Adolescence
Pruritis and oedema - oral cavity - after eating raw frauit and vegetables
hay fever.
Give four presentations of IgE mediated food allergy.
Urticaria/ angioedema
Food pollen syndrome
Food associated exercise induced anaphylaxis (celery, wheat and shellfish)
Anaphylaxis
Give four presentations of non-IgE mediated food allergy phenotypes.
Proctocolitis
Enterocolitis
Eosinophillic oesophagitis
Food protein induced enterocolitis syndrome
Give three foods associated with food associated exercise induced anaphylaxis.
Wheat
Shellfish
Celery
What is pollen food syndrome often associated with?
Hay fever
What are common food allergies in infancy?
Milk, egg and peanuts
Name 3 formulas that can be used in the management of milk allergy.
Extensive hydrolysed formula
Amino acid formula (plant based)
Soya based
What is the risk with FPIES?
Infants - profuse vomiting and diarrhoea - shock can occur due to dehydration.
Why does processing and heating food lower allergenicity?
Destroys conformational folded epitopes which are recognised by auto-antibodies.
How would you screen for food allergy in IgE and non-IgE mediated food allergy?
Downside of screening tests for IgE mediated?
Skin prick tests
IgE assay
Elimination diet
Do not correlate with or predict the severity of an allergic reaction
Determine presence of sensitivity not allergy.
What is the principle behind milk-reintroduction?
Start with more denatured milk protein sources of lower dose which are subsequently less allergenic, and move onto less denatured doses of higher protein content.
