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Food Allergy - Coggle Diagram
Food Allergy
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Intro
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Usually IgE mediated, but sometimes non-IgE mediated
Usually primary (immune tolerance never developed), but can be secondary
commonest in infants = milk, egg, peanut
commonest in older children = peanut, tree nut, fish, shellfish
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milk + egg allergies often resolve in early childhood, nuts + seafood usually persist into adulthood
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Non-IgE-mediated allergy
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Dx relies on hx, exam, sometimes endoscopy + intestinal bx for eosinophilic infiltrates
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IgE-mediated allergy
urticaria, facial swelling, anaphylaxis 10-15 min after ingesting food
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RAST + skin prick a/w false +ves, but have high NPV
the greater the response, the more likely the child is to be allergic
Clinical course
early phase
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urticaria, angioedema, sneezing, bronchospasm
late phase
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nasal congestion, cough, bronchospasm
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Secondary food allergy
usually due to cross-reactivity between proteins in fruit, veg, nuts + pollen
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usually mild reaction, itchy mouth but no systemic sx
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Hygiene hypothesis
risk of allergy lower in younger children, large families, children raised on farms
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