FCAAIA Notes: I have posted many articles about sublingual immunotherapy (SLIT, under-the –tongue) on our web site. Only grass and ragweed tablets are currently licensed in the United States. All other forms of SLIT in the US are not FDA approved and are “off-label”.
In general, allergy shots are at least as or more effective than SLIT. In this study, dust mite SLIT was compared to placebo, but not to dust mite shots. Continue reading
FCAAIA Notes: Children drink less milk than they did a generation or so ago. Even children without milk allergy have a very high rate of vitamin D insufficiency and deficiency as was the case in this study. However, the cow’s milk allergic patients in this study had lower bone mineral density than non-allergic controls. Their calcium intake was significantly lower.
If your child has cow’s milk allergy, check with your pediatrician about supplements Continue reading
FCAAIA Notes: Epinephrine (adrenalin) is the treatment of choice for anaphylaxis. Delay in administration of epinephrine is the major risk factor for poor outcomes in anaphylaxis, including anaphylactic death.
Patients at risk for anaphylaxis should own an epinephrine auto-injector (e.g., EpiPen) and know how to use it. Continue reading
FCAAIA Notes: There have numerous studies over the last 25 years showing that specialists’ care of asthma results in better control and is less expensive over time (including hospitalizations and emergency visits) than that of non-specialists. This is one more study making the same conclusion.
Why do specialists have better outcomes? There must be many reasons, but some of the most likely possibilities include Continue reading
FCAAIA Notes: Patients with immune deficiency disease do get any more viral upper respiratory tract infections than anyone else. What they do get, is more frequent complications of those infections (ear and sinus infections and pneumonia). Most patients with recurrent ear, sinus, and lung infections do not have immune deficiency, but it is always a consideration. Those infections are often “over-treated” and are not bacterial at all or are complications of allergic rhinitis or asthma. So, other factors as described below need to be considered. Continue reading
FCAAIA Notes: The EAT study described here was a natural follow-up to last year’s LEAP study. Unfortunately, the protocol was very difficult to follow as it required that some 3-6 month old children were given a relatively large amount of several highly allergenic foods under a strict schedule. So the majority of enrollees didn’t get enough of the foods that the authors could examine the data as they had hoped. All babies were breast fed and the control group was given no solids before 6 months old.
Nonetheless, there was still a lower incidence food allergy overall and of peanut and egg allergy in in particular in those who were given the solids early Continue reading
FCAAIA Notes: Last year, I reported herein the results of the LEAP study in which it was proven that early peanut introduction to at-risk infants decreased their rate of developing peanut allergy by age 5 by 80%. If you didn’t read it here, you might have heard it on CNN or read it in the New York Times….the news was THAT important.
In the LEAP-On study, those peanut tolerant patients were then told to stop eating peanut for one year after which they were given peanut. There was no increased risk of them developing peanut allergy within that year. Continue reading
FCAAIA Notes: Allergies, like any other chronic disease (yes, allergies ARE a chronic disease), has secondary psychosocial factors affecting the patient’s overall well-being. Food allergy has proven impact on quality of life, so it is not surprising that affected patients have higher rates of emotional and behavioral problems than those without allergies.
So, what can we do? Continue reading
FCAAIA Notes: Frankly, I don’t know anyone who has ever said that food allergy causes atopic dermatitis (AD). However, it is correct that food allergy often triggers AD flares (just as tree pollen doesn’t cause asthma or allergies, but it triggers them). Children with AD are more likely than adults to have food trigger their symptoms. Continue reading
FCAAIA Notes: Atopic dermatitis (AD) is not an indication for allergen immunotherapy (allergy shots) because there are not enough data to prove its efficacy for the condition. However, many patients with allergic rhinitis and/or asthma (which ARE indications for allergy shots) also have AD.
When I was doing my allergy/immunology fellowship, we were taught Continue reading