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Most children who are allergic to cows' milk have been helped by the availability of casein hydrosylate formula. Additional allergies to this formula are known but documentation is limited. A case is described of a three-year-old with a family history of sensitivity to cows' milk and peanuts, who was tested with a small amount of dilute formula by an allergist. Immediately, the child began vomiting violently and had difficulty breathing. Epinephrine was administered to ease the discomfort. Further testing showed an intolerance to many other foods including wheat, soy, corn, oat apple, banana and egg. As long as milk proteins are excluded from the diet, the child maintains good health. The clinical findings of an infants' allergic reaction to casein hydrosylate formula are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

The practice of food allergy (FA) for clinicians has boomed, with a dramatic rise in the number of patients and families seeking care and with many advances on several fronts. The practice itself sometimes is evidence-based science and sometimes an art of pattern and phenotype recognition. This article examines the tools for diagnosis and management and therapy options available to physicians providing care for patients with FA. The article touches on pressing needs of clinicians and highlights the rapid and important movements in national and international support and advances that will have a positive impact on the field of FA.

To provide a brief overview of the clinical presentation, common offending agents, management, prognosis, and mortality of 6 selected high-risk drug rashes, namely, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, multiple drug hypersensitivity (MDH) syndrome, acute generalized exanthematous pustulosis (AGEP), and drug-induced bullous pemphigoid (DIBP).

What food allergy is--and isn't Is there really a connection between food and such symptoms as arthralgias, depression, hyperactivity, or migraine? Here's help for finding--and managing--the truly food-allergic person. EXPRESS [...]

To alert physicians about the peculiar adverse effects of antiepilepsy drugs (AEDs) on the immune system.

Current estimates from various countries suggest that up to 5%-8% of children and 2%-19% of adults have food allergies. Substantial proportions are allergic to cow's milk, eggs, seafood, or peanuts--and [...]

Current estimates from various countries suggest that up to 5%-8% of children and 2%-19% of adults have food allergies. Substantial proportions are allergic to cow's milk, eggs, seafood, or peanuts--and [...]

Infliximab is a highly effective monoclonal antibody against tumor necrosis factor, which is a major inflammatory mediator in certain gastrointestinal, rheumatic, and skin diseases. In some patients, infliximab infusion causes systemic adverse reactions that often lead to discontinuation of therapy even in responsive patients.

Cough is probably the most common cause of seeking medical care in pediatric practice. Most acute cough is caused by infection and usually resolves within less than 4 weeks. If it lasts longer, it is considered chronic and deserves investigation to identify the underlying cause, which can be almost any of a wide variety of illnesses of the respiratory tract and certain extrathoracic conditions. This review provides an optimal approach for diagnosis through a skillful history taking, physical examination, and selection of appropriate tests. Cough is probably the most common cause of seeking medical care in pediatric practice. Most acute cough is caused by infection and usually resolves within less than 4 weeks. If it lasts longer, it is considered chronic and deserves investigation to identify the underlying cause, which can be almost any of a wide variety of illnesses of the respiratory tract and certain extrathoracic conditions. This review provides an optimal approach for diagnosis through a skillful history taking, physical examination, and selection of appropriate tests. [[Pediatr Ann. 2014;43(8):e176–e183.]

To raise awareness among healthcare providers about the clinical and laboratory findings in acute and chronic food protein-induced enterocolitis syndrome (FPIES).

To provide a review on spice allergy and its implementation in clinical practice.

Peanut allergenicity has been reported to be influenced by heat treatment, yet the commonly available extracts for skin prick testing (SPT) are derived from raw extracts.

Limited data are available on the presence of a systemic measure of inflammation in asthma. One marker that has been reported is C-reactive protein (CRP).

To provide an overview on the role of gut mucosal immunity in the development of tolerance to food versus allergy to food.

To provide an updated concise review on food additives adverse reactions, diagnosis, and management.

In a previous study, we noted immunologic abnormalities in 46 (54.8%) of 84 individuals with dysmorphic disorders.

To provide information on certain formulas that are relevant to allergy practice, focusing on their protein source and allergenicity, and to provide recommendations for selecting an optimal formula, taking into consideration efficacy, safety, palatability, and cost.

Asthma is an inflammatory disease, yet clinical tools that evaluate asthma control do not include measures of inflammation.

Food allergy (FA) practice varies widely.

Food allergy (FA) prevalence is increasing and is being popularly claimed by the general population.

To review the current pathophysiologic mechanisms and recent therapeutic trends in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

To summarize the literature related to the classification of food additives and their reported adverse reactions and to provide a practical approach for evaluation of patients suspected of having such reactions.

Purpose: IL-13, RANTES (Regulated on Activation, Normal T cells Expressed and Secreted), and cysteinyl leukotrienes are asthma and atopy mediators. Two RANTES -403(G to A) and -28(C to G), an -1055 IL-13(C to T), and a -444(A to C) leukotriene C4 synthase (LTC4S) single nucleotide polymorphisms (SNPs) have been shown in Caucasians and Asians as asthma and atopy risk factors. We studied these SNPs in African Americans with asthma and/or atopy.Methods: We studied 61 patients with asthma and/or atopy and 129 to 157 newborn controls for the -403 RANTES, -28 RANTES, and -1055 IL-13 SNPs, as well as 47 patients and 60 newborn controls for the -444 LTC4S SNP.Results: The two groups did not significantly differ at the genotypes of the -403 and -28 RANTES SNP. On the other hand, the mutant TT genotype for the -1055 IL-13 SNP was detected in 19.7% of patients versus 12.7% in controls (P < 0.04, OR 2.9, 95% CI 1.0–8.0), and the mutant T allele in 58.3% versus 36.6% in controls (P < 0.02, OR 2.4, 95% CI 1.1–5.2). In a similar fashion, for the -444 LTC4S SNP, the mutant AC genotype was detected in 19.1% versus 10.0% in controls (P > 0.28); mutant C allele had an OR of 2.1 (95% CI 0.7–6.3).Conclusion: African American asthmatics/atopics had higher frequency of the TT mutant gene for the -1055 IL-13 SNP and of its mutant T allele. Regarding the -444 LTC4S SNP, there was a definite difference, although not statistically significant, with an OR of 2.1 for the mutant AC genotype in patients. If these findings become reproduced by larger studies, it may suggest that IL-13 and LTC4S SNPs can be used as predictive markers for asthma/atopy in African Americans.

Adverse reactions to food are common but only a fraction of them are due to hypersensitivity (or allergy). Of the latter, immunoglobulin (Ig)E-mediated reactions appear to be the most common and best understood. A wide variety of manifestations may affect various body systems, particularly the gastrointestinal tract, skin and respiratory tract. Diagnosis depends primarily on thorough medical history, often supplemented by skin testing or specific serum IgE antibody measurement. Verification would require appropriately designed challenge testing. At present, treatment is primarily strict avoidance of the offending food, together with crossreacting other foods. Several immunomodulatory therapeutic agents are being explored. A few studies demonstrated a potential benefit of probiotics for prophylaxis and treatment. A multicenter study is currently investigating the efficacy and safety of anti-IgE in subjects with peanut allergy. Experimental studies in mice revealed preliminary findings that promise vaccine development using novel approaches, such as modified food allergen epitopes, immunostimulatory sequence-conjugated allergens and chimeric proteins capable of complexing with IgE or its receptors.

The perception, by both the public and health professionals, of the clinical expressions of food allergy (FA) varies widely, from one extreme of nonexistence to another extreme of causing almost every ailment. Critical investigations in recent years led to a better clarification, as well as a reasonable classification, of FA manifestations.

Food allergy is gaining substantial interest by both the public and health professionals. It is usually overdiagnosed by the public and misdiagnosed by physicians.

Although cow's milk allergy (CMA) and cow's milk intolerance (CMI) are two different terms, they are often used interchangeably, resulting in confusion both in clinical practice and in research reports.

This article reviews current concepts of the innate immune system that offers protection against infections. It offers an overview for the readers to understand how innate immunity, consisting of different receptors, cells, and mediators recognizes pathogens and exerts protective function against pathogens.

Background:The patch test is an important tool for the diagnosis of contact dermatitis. In the past few years, allergists have shown increased interest in the diagnosis of contact dermatitis and the use of patch testing. Objective:The aim of this study was to determine (1) the frequency of usage of the patch test among allergists, (2) the factors that affect the decision to patch test, and (3) the need for training the allergist to perform patch testing. Method:A single mailing survey was sent to all the members of the American College of Allergy, Asthma and Immunology (ACAAI). Results:Fifty-seven percent of responding allergists performed patch testing but did so infrequently. Those who were fellowship trained in patch testing or attended a sponsored workshop performed the test more frequently than those with no training. Those who perceived the patch test as useful also were more likely to perform the test. Fellowship-trained members felt more confident than workshop-trained members in performing the test, and both, in turn, were more confident than members with no training. Trained physicians also were more likely to find the test useful compared with those with no training in patch testing. Conclusions:Education through fellowship training and workshop was associated with greater self-confidence of the allergist in his/her ability to perform patch testing. Education also was associated with increased perception of patch test utility and increased usage of the test.

This review is intended to provide an outline for the evaluation of patients suspected of having immunodeficiency, a problem that is frequently encountered in clinical practice.

Ingestion is the principal route for food allergens, yet some highly sensitive patients may develop severe symptoms upon skin contact.

This presentation is designed to critically review information on presentations of food hypersensitivity reactions that may be considered unusualregarding the source or nature of allergen, route of exposure, or clinical manifestation.