Food Allergy - a Twitter summary from the 2011 ACAAI meeting

This summary was compiled from the tweets posted by some of the allergists who attended the 2011 ACAAI meeting. The tweets were labeled #ACAAI. The text was edited and modified by me.

Genetics

One parent with food allergy doubles risk of food allergy in kids (offspring). If both parents have, there is triple the risk of food allergy in offspring (Finnish data).

Camel milk in cow’s milk allergy (CMA)

Camel milk lacks beta-lactoglobulin, but 20% of patients with cow’s milk allergy (CMA) still react to it. Camel milk can still cause anaphylaxis. A prick test with camel milk may be helpful.

Baked milk in cow’s milk allergy (CMA)

Among baked milk tolerant children, 60% tolerated unheated milk over a 5-year period. That group was 28 times more likely to become tolerant to milk.

There was a significant reduction in milk allergy if the children were continually fed baked milk - 76-80% of the “treatment group” outgrew CMA vs. 24-33% in the control group.

Peanut allergy

The best individual marker for peanut allergy is IgE to r Ara h2. IgE to Ara h6 increases specificity.

Peanut oral immunotherapy (OIT)

In a peanut OIT study, 10% of patients required epinephrine treatment during dose escalation in the hospital but 84% of patients completed 1 year of OIT. The desensitized group was able to tolerate 5 gm of peanut vs. the placebo group was able to tolerate only 280 mg of peanut.

Side effects were common among 103 patients treated with the study protocol: 34% had moderate abdominal pain, sometimes with vomiting, and another 30% had mild abdominal pain (that’s a total of 64% with abdominal pain). Just under 40% of patients complained of oral pruritus, 8% had hives, and respiratory symptoms were reported by 7%. Only 28% experienced no symptoms at all with OIT (72% of patuients had symptoms with OIT). Source: Oral Tx for Peanut Allergy a Viable Option, MedPage Today.

The place of oral desensitization in the practice of allergy at this time is in flux - see why: http://goo.gl/gNKLD

Food challenges

Food Challenges Provide Best Allergy Diagnoses. Only 15% of food-allergic kids have food allergy confirmed through best way to diagnose - an allergist-supervised oral food challenge. Source: USNews.com

Influenza vaccine and egg allergy

Flu vaccine administration was associated with mostly mild hives (4%) even in severe cases of egg allergy. In patients with mild egg allergy (hives only, after egg ingestion), you can addminiter the vaccine in PCP office. For severe egg allergy, administer the influenza vaccine in an allergist office (AAP guidelines).

In summary, in egg allergic children with hives only, flu vaccine can bu given by PCP. If there are more severe symptoms, an undivided dose should be given at allergist's office with a 3-minute observation.

Single Flu Shot Safe for Most Children With Egg Allergy (10/90 split may not be needed) - see allergist for evaluation. Source: Medscape.

This summary was compiled from some of the tweets posted by Dr. David Fischer @IgECPD4, Robert Silge, MD, @DrSilge, Danny Ramirez, MD @allergysa, and a few others. The tweets were labeled #ACAAI and they reached more than 10,000 people. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Disclaimer: The text was edited, modified, and added to by me.