Allergy for the General Paediatrician - Derby GP Specialty ：过敏一般儿科医生德比GP专业.pptVIP

Investigations SPT Hazelnut 7mm Almond 5mm Walnut 4mm Peanut 0mm Advice – avoid all nuts Rx - Epipen as mild asthma, 12yrs and possible upper airway involvement Food challenge to nutella (very keen to eat!) Case cont: Food challenge –Nutella : no reaction When Seen again reaction to apple – oral tingling, nil else Bloods taken: IgE hazlenut – 40 (grade 4) IgE apple 3.3 ( grade 3) Birch pollen – positive, grade 3 CRD’s – Cor a8 - 0.3 ( LTP protein – heat stable) Cor a1 – 42.6 (PR10 protein, heat unstable) Diagnosis : Oral allergy syndrome Management – no need for AAI, v unlikely to have systemic reaction Oral allergy syndrome(pollen-associated food allergy syndrome) Pruritis and mild oedema to oral cavity uncommonly progressing beyond the mouth (7%) and rarely anaphylaxis (1-2%). Possibly more common in pollen season Raw fruits and vegetables; cooked forms tolerated. Examples of relationships: Birch (apple, peach, pear) Ragweed (melons) Oral allergy syndrome:cross reactivity between foods Oral allergy syndromeFoods that may cause reactions in individuals with pollen allergy That really is all! * * Nut Allergy Peanuts = legumes/ ground “nuts” Brazil, hazel, almond etc = Tree nuts In general, avoid all “nuts” AAI…..? Adrenaline autoinjectors Anapen_Lincoln Medical JEXT_ALK EpiPen_Meda Old and New Prescription of Adrenaline Auto Injectors “AAI”(e.g. JEXT/ Epipen) Absolute indications: Previous anaphylaxis triggered by food, latex or aeroallergens Exercise-induced anaphylaxis Idiopathic anaphylaxis Co-existing unstable or moderate to severe, persistent asthma and symptoms of IgE mediated allergy Venom allergy in children with more than cutaneous/mucosal systemic reactions. AAI prescription Relative indications : Possible food allergy and 2 or more of following risk factors: Mild-to-moderate allergic reaction to peanut and/or tree nut Older age 12yrs Remote from medical help and previous mild to moderate allergic reaction to a food, ven