Paediatic Allergy

Question 1

What are the pathophysiological mechanisms of IgE mediated allergy?

Answer 1

X

Question 2

What are the presenting features suggestive of IgE mediated food allergy and how do you elicit an allergy focused history?

Answer 2

X

Question 3

How would you formulate and justify a diagnosis of IgE mediated allergy?

Answer 3

A Clear history, know the worst reaction, supporting evidence from investigations, identify and advise on allergen

Question 4

What investigations are appropriate to aid the diagnosis of suspected food allergy?

Answer 4

Skin prick testing - easy, quick, non invasive, immediate results, cheap
Specific IgE - no risk of reaction, costly, invasive, no need to stop antihistamines, delay for results
Oral food challenge - day case, gold standard, what actually happens

Question 5

What is the management for the prevention and treatment of food allergy including symptoms?

Answer 5

Prevention - avoid allergen
Treatment - anti histamine, adrenaline injectors (previous anaphylaxis or at risk of anaphylaxis.. or parents desperate for one) dietary advice, optimise asthma control
Key symptoms - Anaphylaxis controlled via adrenaline pens (need education on use)