3 - Paeds - Gastro - Food allergy/Intolerance Flashcards Preview

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Flashcards in 3 - Paeds - Gastro - Food allergy/Intolerance Deck (10):
1

Allergy?
Intolerance?

pathological immune response against specific food protein - usually IgE mediated

non-immune hypersensitivity reaction

2

Type 1 allergies occur because? 3 infant agents, 4 older kids agents?

kids don't develop immune tolerance to food
infants - milk, eggs, peanut
older kids - peanut, tree nut, fish and shellfish

3

type 2 allergies.. allergy begins later because...? how severe are these compared to type 1

begins later due to cross-reactivity between proteins in fresh fruit/veg/nuts and those in pollens (eg tolerates apples > dev allergy to birch tree pollen > dev allergy to apples (v similar proteins)

usually more mild

4

what is diff between mediation of type 1 and type 2
non-allergic/hypersensitivity Sx?

type 1 - ige mediated
type 2 - non-ige mediated

D+V, watery stools

5

clinical features of type 1 - Sx, time after ingestion

Hx of allergic Sx - urticarial rash to facial swelling to anaphylaxis - usually 10-15m after ingestion, usually first time food is ingested

6

clinical features of type 2 - 4 main Sx, 2 other possible Sx, what is possible in first few weeks of life

abdo pain, D + V, FTT
colic/eczema
sometime blood in stools in first weeks of life from proctitis

7

gold standard for diagnosis of BOTH allergy types

withdrawal of food from diet under dietician supervision - followed by double blind placebo controlled food challenge in hospital with close monitoring

8

how is non-Ige mediated diagnosed (type 2)

by Hx + Ex, endoscopy/biopsy may be used, supported by eosinophilic infiltrates

9

how is IgE mediated allergy diagnosed? type 1

skin prick test and measurement of specific IgE Abs in blood - ^ response = like to be allergy - -ve response makes allergy unlikely

10

MGMT

avoid relevant foods
advice of paed dietician
self mgmt plan and training for an attack
antihistamines for mild
epipen for severe

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