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Food allergy and anaphylaxis in pediatrics: update 2010-2012

Authors

  • Alexandra F. Santos,

    Corresponding author
    1. Immunoallergology Department, Coimbra University Hospital, Coimbra, Portugal
    2. Gulbenkian Programme for Advanced Medical Education, Lisbon, Portugal
    • Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
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  • Gideon Lack

    1. Department of Pediatric Allergy, Division of Asthma, Allergy & Lung Biology, King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
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Correspondence

Alexandra F. Santos, Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, Guy's Hospital, 5th Floor Tower Wing, London SE1 9RT, UK.

Tel.: +44 0 20 7188 0605

Fax: +44 0 20 7403 8640

E-mail: alexandra.santos@kcl.ac.uk

Abstract

This review highlights the progress made in food allergy (FA) and anaphylaxis research in pediatrics published in the journal Pediatric Allergy and Immunology since 2010. Putative risk factors for FA are as follows: a family history of allergic disease, particularly in the mother, low birth order, season of birth, and severe atopic eczema. Obstetric practices, antibiotic use, and home environment are factors deserving further research. Diagnostic decision levels and component-specific IgE are useful in the diagnosis of FA; however, oral food challenges remain the gold standard and may also be a means to reduce parental anxiety and to improve education. Oral immunotherapy studies show promise in increasing the threshold of reactivity of allergic patients and therefore improving their quality of life. In single-nut-allergic patients, introduction of other nuts allows broadening the diet and thus reducing the psychological impact of allergen avoidance. Nutritional deficiencies are not uncommon in food-allergic children and should be specifically assessed. The prescription of injectable adrenaline is still insufficient and not consistent among practitioners, requiring improved training and implementation of guidelines. Current research into the epidemiology and immunological mechanisms of FA and tolerance will enable us to devise strategies to both prevent and treat food allergies.

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