week 11 Flashcards
Importance of recognising eczema as a risk factor for food allergy
~ 40% of young children with chronic eczema have an associated food allergy
~ 90% of children with food allergy have eczema
Diagnosis of food allergy may be unsuspected
Foods may be tolerated without acute / severe reactions if eaten
regularly by children with chronic eczema
Eliminating foods & later re-introduction may provoke anaphylaxis
Filaggrin
Filaggrin (protein essential for formation and hydration of skin barrier) and atopic dermatitis
Strong association between the filaggrin gene defect and sensitization to food allergens, dust mite allergen and asthm
90% allergic reactions from
Egg, milk, peanuts, tree nuts, fish, crustacean shellfish, soy and wheat responsible for over 90%allergic reactions
skin prick testing
Detects iGE antibodies not disease
Eczema and barrier function
If you have eczema, your skin may not produce as much fats and oils as other people’s, and will be less able to retain water. The protective barrier is therefore not as good as it should be. Gaps open up between the skin cells because they are not sufficiently plumped up with water.
Adrenaline autinjectors
- Epipen
- Jr 150 micrograms (10-20kg)-
300 micrograms (>20kg)
Sources of allergen contact
Cross contamination- Contaminated kitchen surfaces- Mixing- Accidental food spills- Close contac
food intolerence
They are triggered by food chemicals which cause reactions by irritating nerve endings in different parts of the body
Diagnostic elimination diet (exclusions)
Natural salicylates- Natural amines- Natural glutamates and added flavour enhancers
- Preservatives- Food colours- +- wheat, milk, soy- +- FODMAP foods
2 weeks - 6 weeks- Withdrawal rwactions- Food and symptom diary- Aim for 5 days in row free of symptoms
Special Diets for specific disorders
Fibromyalgia: Low ‘excitotoxin’ (glutamate) diet
Irritable Bowel Syndrome: Low FODMAP die
Migraine, urticaria, angioedema, MCAS: Low histamine diet
Eczema, ADHD, Urticaria: Oligoantigenic diet
