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Immune System > Food Allergy > Flashcards

Food Allergy Flashcards

1
Q

Allergen

A

Substance that stimulates the production of IgE or a cellular immune response

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2
Q

Hypersensitivity

A

Inappropriate or excessive response to a stimulus

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3
Q

Sensitisation

A

Production of IgE antibodies after exposure to an allergen

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4
Q

Atopy

A

Tendency to produce IgE antibodies in response to ordinary exposure to potential allergens

Associated with:

  • asthma
  • rhinitis
  • eczema
  • food allergy
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5
Q

Presentation of allergy

A

Allergic rhinitis: triggered by pets, house dust mites and pollen

  • blocked or runny nose
  • itchy nose
  • sneezing

Allergic conjunctivitis
- red, swollen, itchy and watery eyes

Asthma

  • wheeze
  • cough
  • SOB
  • tight chest

Atopic dermatitis (eczema)

  • chronic inflammatory skin disease
  • itch and excoriation

Urticaria (hives)

  • maculo - papular pruritic rash
  • +/- angioedema
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6
Q

Insect allergy

A

Mild - local itchyness, erythema
Moderate - urticaria
Severe - anaphylaxis

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7
Q

Allergies as one ages

A

Rhinitis prevalence increases with age

Asthma, eczema and food allergy decreases with age

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8
Q

Milk allergy

A

Presents before 1 years old

Symptoms can present many weeks after exposure

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9
Q

Types of presentation

A

IgE mediated (40%)

  • immediate onset
  • affects skin, GI and resp tract
  • urticaria, cough wheeze, vomiting and diarrhoea
  • can cause anaphylaxis

Non IgE mediated (60%)

  • delayed onset
  • FPIES - food protein induced enterocolitis syndrome
  • predominately multiple GI symptoms
  • resolves earlier
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10
Q

Why is non IgE mediated allergy harder to diagnoses

A

Seen in younger patients - infancy and early childhood

Similar presentation to reflux and colic diseases

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11
Q

Common symptoms of food induced anaphylaxis

A

Coughing and scratching at throat
Malar flush
REPEATED vomiting
Generalise urticaria

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12
Q

Common food allergens

A 
Celery 
Crustaceans 
Eggs
Fish 
Lupin - in flour 
Milk 
Molluscs 
Mustard 
Nuts 
Sesame seeds
Soya 
sulphites - beer
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13
Q

Non immune mediated food intolerance

A

Metabolic e.g lactose intolerance
Psychological - food aversion
Toxic - scromboid dish toxin in fish that is not kept cold

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14
Q

Food associated exercise induced anaphylaxis

A

Food triggers anaphylaxis only when exercise is done after within 2 hours

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15
Q

Pollen food syndrome

A

Pollen in fruit can cause pruritis and mild oedema confined to the oral cavity

Rarely progresses

Associated with hay fever, raw fruit and veg

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16
Q

Proctocolitis

A
  • inflammation of rectum and colon
  • passage of bright red blood in mucous stool in otherwise asymptomatic infants
  • due to milk allergy whilst breastfeeding
17
Q

Eosinophilic oesophagitis

A

Oesophageal inflammation and scarring of feeding disorders

  • reflux
  • vomiting
  • dysphasia
  • food impaction
18
Q

Food Preston induce enterocolitis syndrome

A 
Primarily affects infants 
Profuse vomiting:
- pallor
- lethargy 
- possible shock 
- diarrhoea
  • looks like sepsis but markers are abscent
19
Q

Change in food allergies

A

Infancy:

  • milk
  • egg
  • peanuts

Early childhood:

  • soya
  • Wheat
  • tree nuts
  • fish
  • kiwi
  • sesame

Adolescence

  • fresh fruit
  • vegetables
20
Q

Casein

A

Protein in milk that is more heat resistant than whey
Whey forms bonds in food - reduces availability and allergenicity
Therefore tolerated baked milk

21
Q

Allergenicity of peanuts

A

Increases if dry roasted

Decreases if boiled or fried

22
Q

Cross reactive food allergens

A

CSF allergic to cows milk 92% likely to be allergic to goats milk

Tree nuts and other tree nuts - 37%
Fish and other fish - 50%
Shellfish - 75%
Pollen and fruits - 55%

23
Q

Food allergy diagnosis

A

Medical history:

  • context of reaction
  • symptoms - timing, duration and severity
  • food considerations - how food is prepared
  • route of exposure
  • age of onset
  • activity at time of exposure - e.g. alcohol

Physical examination

Screening tests:

  • skin prick tests
  • blood specific IgE
  • elimination diet

Diagnosis verification: food challenges

24
Q

Immunoassay to detect allergen specific IgE

A

Allergen bound IgE is detected by an enzymatically labelled anti human- IgE monoclonal antibody

25
Q

Skin prick test

A
  • Determines sensitisation

- size of skin prick test correlates with likelihood of allergy but not severity

26
Q

Management of food allergy

A

Identify food causing symptoms

Dietary advice:

  • exclusions
  • inclusions
  • label reading
  • food reintroductions

Medical advice:

  • emergency management of anaphylaxis - epipen
  • allergy to food - antihistamine
27
Q

Management of milk allergy

A

Replacement infant formulas:

  • extensive hydrolysed formula
  • soya - more than 6 months old
  • amino-acid formula
  • dairy free weaning advice followed by reintroduction
28
Q

Milk reintroduction

A

Stage 1 - small crumb of biscuit then to whole biscuit in 5 weeks
Stage 2 - bakes products containing calein milk products
Stage 3 - products containing cooked cheeses or whole cow’s milk
Stage 4 - uncooked cheese, non yoghurt desserts like ice cream

Immune System (6 decks)

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