Food allergy anaphylaxis

The Food Allergy Anaphylaxis Network and Shindeh Mofidi, Eds., 2004. A Health Professional s Guide to Food Challenges. S. Alan Bock (Medical Editor). The Food Allergy Anaphylaxis Network, Fairfax, VA. 

Food Allergy Anaphylaxis Network (FAAN) http //www.foodallergy.org... 

The most frequent elicitators of food allergy in children are peanuts and tree nuts [ 17]. In France the prevalence of food allergy has been estimated to be 3.2% [18]. Furthermore, in this study, food was identified as the most common cause of anaphylaxis. Here the major identified food allergens besides peanuts and tree nuts were shellfish, wheat and lupine flour [18]. 

These data suggest that due to an increase of food allergy and in particular tree nut and peanut sensitization, the risk for anaphylaxis has been increased at the same time. 

The role of atopy in anaphylaxis has not completely been resolved. On the one hand there is for example no evidence of a higher risk of severe reactions in venom-allergic patients. A recent study by Sturm et al. [38] indicated that patients with high total IgE levels predominantly developed mild to moderate reactions. By contrast, atopy may increase the risk and severity of systemic reactions in beekeepers and their family numbers [39]. On the other hand, atopy and in particular allergic asthma are risk factors for food allergy and therefore are also important risk factors for food-induced anaphylaxis. This is most likely also true for exercise-induced anaphylaxis, but also non-IgE-dependent anaphylaxis induced by NSAIDs or contrast media. 

Sampson HA, Munoz-Furlong A, Campbell RL, et 38 al Second symposium on the definition and management of anaphylaxis summary report-Second National Institute of Allergy and Infectious Disease/ 39 Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 2006 117 391-397. 

To date, no studies have been published on the sensitivity and specificity of the determination of specific IgE against foods in series of patients experiencing anaphylaxis as a manifestation of their food allergy. However, in general it is assumed that the determination of specific IgE against animal foods offers better results than the determination of specific IgE against plant foods, both in terms of sensitivity and specificity. 

Ebo DG, Ahrazem O, Lopez-Torrejon G, Bridts CH, Salcedo G, Stevens WJ Anaphylaxis from mandarin (Citrus reticulata) identification of responsible allergens. Int Arch Allergy Appl Immunol 2007 144 39-43. Raap U, Schaefer T, Kapp A, Wedi B Exotic food allergy anaphylactic reaction to lychee. J Invest Allergol Clin Immunol 2007 17 199-201. 

Oren E, Banerji A, Clark S, Camargo CA Jr Food-induced anaphylaxis and repeated epinephrine treatments. Ann Allergy Asthma Immunol 2007 99 429-432. 

Jarvinen KM, Sicherer SH, Sampson HA, Nowak-Wegrzyn A Use of multiple doses of epinephrine in food-induced anaphylaxis in children. J Allergy Clin Immunol 2008 122 133-138. 

Bock, S. A., Munoz-Furlong, A., and Sampson, FI. A. (2001). Fatalities due to anaphylaxis reaction to foods. /. Allergy Clin. Immunol. 107,191-193. 

Frick OL, Teuber SS, Buchanan BB, Morigasaki S, Umetsu DT Allergen immunotherapy with heat-killed Listeria monocytogenes alleviates peanut and food-induced anaphylaxis in dogs. Allergy 2005 60 243-250. Stock P, Akbari 0, DeKruyff RH, Umetsu DT Respiratory tolerance is inhibited by the administration of corticosteroids. J Immunol 2005 175 7380-7387. 

Only nine allergic reactions to cuttlefish have been described (Caffarelli et ah, 1996 Ebisawa et ah, 2003 Shibasaki et ah, 1989). One patient was a 10-year-old female who experienced a severe reaction to ingestion of cuttlefish that was manifested by urticaria, angioedema, asthma, abdominal pain, laryngeal edema, and hypotension (Shibasaki et ah, 1989). SPT and RAST were positive. This patient reportedly tolerated octopus, clam, oyster, abalone, mussel, and scallop but reacted to crab and shrimp. Caffarelli et ah (1996) describe a 14-year-old female who had cuttlefish-dependent, exercise-induced anaphylaxis. Ebisawa et ah (2003) reported 7 cases of allergy to cuttlefish among a series of 305 pediatric cases of food allergy but provided no specifics on the circumstances or symptoms of these patients. 

Shida K, Takahashi R, Iwadate E Lactobacillus casei strain Shiroto suppresses serum immunoglobulin E and immunoglobulin G1 responses and systemic anaphylaxis in a food allergy model. Clin Exp Allergy 2002 32 563-570. 

In food allergy, serum IL-5 was found to be elevated in infants with anaphylaxis to cow s milk at 1 week, but became undetectable after 2 weeks on a milk-free diet (M9). It seems likely that the allergic inflammation due to cow s milk or other food allergens can induce marked eosinophilia with an associated increase in IL-5 production. Therefore, IL-5 may serve as a marker for food allergy. Other studies have also shown that IL-5 expression correlates significantly with eosinophilia and allergic symptoms of allergic rhinitis in patients with hay fever (W13). 

The probability of occurrence of sudden death due to the food anaphylaxis has been calculated over 10 years retrospective research at 0.06 deaths in 1,000,000 in children aged 0-15 per year based on results of 10 years retrospective studies. The most frequent allergen was cow s milk accounting for approximately 50% of deaths. Also, severe anaphylactic reactions were observed following the consumption of nuts. That estimated probability of death occurrence is 1 in 800,000 children per year, assuming that 5% of the population exhibits symptoms of food allergy (Macdougall et al., 2002). 

Double-blind placebo-controlled—neither the patient nor the physician is aware of the challenge content (Niggemann et al., 1994 Kaczmarski et al., 1997 H0st et al., 2003 Bindslev-Jensen et al., 2004 The Food Allergy and Anaphylaxis Network, 2005 Nowak-Wegrzyn and Sampson, 2006). 

Prior to oral food challenges, patients should avoid the suspected food(s) for at least two weeks and discontinue antihistamines or long-term asthma medications (beta-agonists) according to their elimination half-life. They should be evaluated carefully, before the challenge, for the presence of any clinical symptoms (The Food Allergy and Anaphylaxis Network, 2005 Chapman et al 2006). 

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