Food allergy-related tweets from 2011 AAAAI meeting

Here are some of the food allergy-related tweets from the 2011 annual AAAAI meeting. They were labeled #AAAAI and based on real time updates by Sakina Bajowala, M.D @allergistmommy and Robert Silge, MD @DrSilge. The text was edited, modified, and added to by me.


The 2010 guidelines for diagnosis and management food allergy: tests should be based on medical history - do not order large panels of food testing. Sensitization alone is not sufficient for diagnosis of food allergy. Diagnosis is based on the combination of sensitization and clinical symptoms.

Delayed anaphylaxis to meat

Delayed anaphylaxis can occur due to alpha-1, 3 galactose in mammalian meats and milk. This is an example of carbohydrate (not protein) allergy. Alpha-gal sensitization may be triggered by tick or chigger bites. Alpha-gal sensitization may be associated with allergic reactions to cetuximab (food allegy link to drug allergy). Related reading: Delayed mammalian meat–induced anaphylaxis due to galactose-α-1,3-galactose in 5 European patients - JACI, 2011 and Ectoparasite-induced Galactose-α-1,3-Galactose–Specific IgE Is Associated with Anaphylaxis but Not Asthma

Advisory labels

Milk protein is found in significant concentrations in products labeled "may contain", "shared equipment", or "shared facility". Recommendation: do not use foods with advisory label. Use caution with unlabeled foods from small companies.

Pregnancy and diet

There is Insufficient evidence to recommend dietary modification during pregnancy. In high risk food allergy families, peanut may be a notable exception.


Soybean oil and soy lecithin are generally well-tolerated in IgE-mediated soy allergy. Soy oil gets a “free pass” for soy allergic patients. Soy lecithin is also not a concern.

There are some patient who can't tolerate the oil and lecithin from soy (if soy-allergic). However, they don't develop anaphylaxis.

Peanut and sesame oils may contain trace amounts of protein (depending on how they are processed), so they should be avoided.

Allergenicity of refined vegetable oils is extremely low

Related reading:
Image source: Roasted peanuts as snack food, Wikipedia, public domain.

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