powerpoint alergy

8/15/2019 Powerpoint Alergy

1/43

GOOD

AFTERNOON


2/43

LITERATURE

REVIEW

DIAGNOSIS AND

MANAGEMENT OF FOODALLERGYBy

Luh Witari Indrayani

Scientifc advis rdr! Made Sudi"ta#S"!T!$!T!%!L


3/43

Food allergy :Collection of symptoms that affect many organsand body systems caused by food allergies.A reaction to a food that is essentially a

hypersensitivity reaction type I (IgE-mediated)a cell-mediated or both.

Food allergic reaction involves three maincomponents:

food allergensimmunoglobulin E (IgE)mast cells and basophils.

INTRODUCTION


4/43

INTRODUCTION

Literaturerevie&

!"E#A$E%CE&nited 'tates : . -*+ ,+ in children under years -,+of school-age children and . + in adults.

/he tendency of increase in the prevalence of food allergies over years to reach + per year.

'ymptoms and signs : varies depending on the organ affectedfor e0ample in the digestive system the respiratory system ors1in.


5/43

INTRODUCTION

Literaturerevie&

%ot all adverse reactions to food is a pure allergic

reactions but many physicians or the general public usethe term food allergy to all un2anted reaction fromfood either immunological or non-immunological.

All of adverse reactions to foods and food additivesappro0imately 3+ due to food allergies.


6/43

yh

Hippocrates

the father ofmedicine was the rst to describe

the food adverse reactions (adversefood reaction) around more than

2000 years ago.

Anaphylactic reaction to egg is rstdescribed by arcello !onati

in the "#$ century.

Anaphylactic reaction to sh is rstdescribed by %hilipp &achs.

At the beginning of ""century several cases of

children with ec'ematous rash

era urerevie&


7/43

yh

$ist ry '$n *0 +oveless rst performa blinded placebo,controlledfood challenges to establish

the diagnosis of food allergy

era urerevie&

$n ay - rst introducedthe use of double,blindplacebo controlled oral foodchallenges/ a protocol that iscurrently considered the goldstandard for diagnosis of foodallergies.


8/43

American Academy of Allergy and Immunology and The National Institute of Allergy and Infections

Disease.

era urerevie&

AD(ERSE FOOD REA)TIONS

$ 1 + 3$4

56A47$ 1

1 1 $ 1 + 3$456A47$ 1

$g 6 1on $g 6%&84H 36

1$49 !

$17 +65A146

7 "$4 9!

% $& 1$13

1 1 7 "$4


9/43

Food allergy aberrant immunological reactionsdue to the entry of allergens into the body of themechanism of this reaction can be mediated by

IgE or non-IgE.

Food intolerance non-immunologic reaction to food and is largely the cause of unwanted

reactions

Food poisoning occurs when foods containingthe to0in

+iterature review


10/43

4etabolic reactions to foodsthe body can not adequately digest the substances

contained in foods

Food idiosyncrasy Quantitative abnormal response to food

substances or adittional substances that differ intheir physiological and farmacologic effects.

+iterature review


11/43

C h i l d r e n • * # + , n e & - r n - a - y c & . s / i 0 1 i n t h e f r s t y e a r 2 0 i 2 e • & a n d ; ' $ y " e r s e n s i t i v i t y r e a c t i n t e 3 3 s c c u r s i n

a " " r 4 i / a t e 0 y 5 ! 6 , 2 c h i 0 d r e n a n d " e a n u t c c u r r e d i n 7 ! + , 2 c h i 0 d r e n

• % e d i a t r i c p o l y c l i n i c 4 i p t o a n g u n < u s u m o H o s p i t a l ' 8 # 9 , 2 d a 0 0 e r 3 y : 5 ; < = > 5 ; ; 9 ?

A d u 0 t • = c h i l d r e n • & ' * , & i t h 2 d a 0 0 e r 3 y • ; ' 5 # 8 > 5 # < , e 4 " e r i e n c e d a d v e r s e 2 d r e a c t i n a n d

7 ! 7 5 t 7 ! * 6 , 2 a d u 0 t s a r e a @ e c t e d - y a d v e r s e r e a c t i n s t 2 d a d d i t i v e s

• * , 2 t h e a d u 0 t " " u 0 a t i n i n t h e 1 e t h e r l a n d s i s a @ e c t e d - y a d v e r s e 2 d r e a c t i n s

6%$!6 $ +38


12/43

9ood allergen 'Allergen class $ 30yc "r tein &ith / 0ecu0ar &ei3ht

2 57>=7 1i0 da0t n# resistant t heat# acid and

"r te 0ytic en y/!

Allergen class $$ e"it "e &hich very unsta-0e thi3h te/"erature#resistant t de3rada-0e en y/#

di cu0t t is 0ate!

4ow>s mil< ' betalactoglobulin :BLG?#alfalactalbumin:ALA?#bovinserumalbumin

:BSA? ,bovingammaglobulin :BGG?Wheat ' albumin,pseudoglobulin and euglobulin

literature

review


13/43

e

Allergens that have been identi ed insome food.

literature

review

9ood product Allergen

5 Mi01 )asein# 0act 30 -u0in#0act a0-u/in* E33 Ova0-u/in# c na0-u/in#

0y" "r tein

6 Ceanut Arachin# 0ectin>reactive30yc "r tein# "eanut I# c narachi

8 S y-ean G0ycinin+ Fish i0 A00er3en M

9 Green -eans A0-u/in

= Rice G0 -u0in r 30ute0in

< t /at G0yc "r tein


14/43

Credis" sin3 2act rs

• a00er3y

+iterature review

Dietaryha-its

F d

"r cessin3

Chysica02act r

Csych 0 3ica0 2act r


15/43

Chat 3enesis 2 2 d a00er3y

+iterature review

3astrointestinal

mucosalbarrier

%hysicochemical

4elluler


16/43

Chat 3enesis 2 2 d a00er3y+iterature review

IgE mediated allergy

5. 'ensiti6ation phaseAntigen catched by B-limphocyte

progenitor antibody-producingcells break the antigen peptide

fragments that bound selectively to themajor histocompatibility comple !"#C$class %% recogni&ed by the ' cell receptoron C() * ' helper cells.


17/43

Chat 3enesis 2 2 d a00er3y+iterature review

IgE mediated allergy:

+. Eliti6ation phase ,n subsequent e posure to the agent whohas been sensiti&ed cells that binds to %g

bound to each other by agent mast cell

produced inflammatorymediator physiologic changes fastallergic reaction skin respiratorygastrointestinal symptom.


18/43

F d a00er3y/ani2estati n

1ausea/vommiting/diarrheaand abdominal pain

rti


19/43

F d a00er3y/ani2estati n

!i?cult to

breath

Hypotensi

+oss ofconscio

usness

Deat

h

Ana"hy0acticsh c1


20/43

F d a00er3ydia3n stic

h i s t r y

• F a / i 0 y h i s t r y • F e e d i n 3 h i s t r y • S i 3 n s a n d s y / " t / s 2 2 d a 0 0 e r 3 y i n i n 2 a n c y t

t h e " r e s e n t c n d i t i n s

I n v i v e 4 a / i n

a t i n • S k i n p r i c k t e s t • I n t r a d e r m a l t e s t • P a t c h t e s t • F o o d c h a l l e n g e t e s t

I n v i t r e 4 a / i n a

t i n • I 3 E e 4 a / i n a t i n • B a s o f l h i s t a m i n e r e l e a s e a s s a y D B $ R ? • I n t e s t i n a l m a s t c e l l h i s t a m i n e r e l e a s e : I M ) $ R ?


21/43

9ood allergydiagnostic

Open foodchallenge

single blind

placebo-controlled foodchallenge

double blind placebo-controlled food

challenge

9ood provocationtest


22/43

9ood allergydiagnostic

7he doctor orthe patient

reali'es thatthe patientsconsume foodthat issuspected

content of thetested foodsare notdisguised.

O"en2 d

cha00en3e

7he s


23/43

ha00en3e9ood allergy

diagnostic

!octor reali'ed

what was eatenby the patientbut the patientdidn>t

7he suspectedfood isdisguised sothe patientdidn>t 2 d

c ntr 00ed2 d

cha00en3e


24/43

ha00en3e9ood allergy

diagnostic

!octor andpatient do not


25/43

4an not bedone in patient

with a history ofapparent

allergic reaction

6liminationdiet at least in

2 wee


26/43

The sus"ected2 d is dis3uisedin ther 2 d r

ca"su0es

Test &ith thether 2 d can

-e d ne n thedi@erent days

T ta0 d se ' 573ra/ dry 2 d#

577 /0 &et 2 d#t& 2 0d 2 r /eat

r fsh

Divided int =d ses '

5,#8,#57,#5+,#*7,#*+, and *+,

Increased every57>67 /inutes and

&ait 2 r itsreacti n 67

/inutes a2ter the0ast d se is 3iven

9ood provocationtest

+i

terature


27/43

Mana3e/ent 2 2 d

a00er3y

+i teraturereview

F dav idan

ce

6limination diet

Autoin ector

devicecontainingephinefrin

e

Bearmedical

alertbracelet or

nec


28/43

eal plan or diet to eliminatefoods must be done carefully.

Any elimination diet should ta


29/43

Mana3e/ent 2 2 d

a00er3y

+i teraturereview

9or successful elimination diet notice food labels.

After conducting strict allergen,freediet for ,2 years one,third ofchildren and adult patients no

longer sensitive to food allergenspreviously.

+i

terature


30/43

Mana3e/ent 2 2 d

a00er3y

+i teraturereview

edical alertbracelet

Auto,in ector epinephrineand how to use it

+iterature


31/43

$mmunotherapy 9or an individual against an

allergen desensiti'ation pollen andother environmental allergens.

$t is not recommended to treat foodallergies dangerous because ofpotential serious anaphylacticreactions

7he only way to prevent an allergicreaction is to avoid the oDendingfood.

3ene therapy for peanut allergy isnow being done.

Mana3e/ent 2 2 d

a00er3y

+iteraturereview


32/43

DIS) SSION

+ o v i c <

• B o m a n E e n • 6 a t i n g h a b i t s i n F u e n c e d

b o d y > s r e a c t i o n

$ n d o n e s i a

• % r e v a l e n c e o f f o o d a l l e r g y * , ( ( G • A l l e r g y $ m m u n o l o g y 4 l i n i c 4 i p t o

a n g u n < u s u m o c o n t a i n e d . G o f f o o d a l l e r g i e s d u r i n g ( ) I - , ( ) )

B o o d s e t a l

• 0 . ( G o f a d u l t s a r e a l l e r g i c t o p e a n u t s

• 0 . 0 ) G o f a d u l t s a r e a l l e r g i c t o e g g


33/43

DIS) SSION

Davis et a0'SA 7!9,

adu0tsa00er3ic t"eanuts

Y n et a0'

6!=, adu0tsa00er3ic tc rn

Li1ura eta0'

a"an E33 isthe cause 2

/ st 2 da00er3ies in

chi0dren a/ untt +*!6,!Bilm et al '

Austra0ia a00er3ic

ch c 0ate as/uch as

*, 7!5>7!*y 01s

&ampson:;7, 2 2 d

a00er3ies arecaused -y ana00er3y /i01#

e33s# "eanuts#s y-eans and

&heat


34/43

DIS) SSION

&ampson:

Adults I*Gcaused bysh/ peanuts

and shell

$n a prospective study ofI0 newborns who were

followed for @ years2IG reported

eJperiencing adverse

reactions food wasmostly occurs in the rstyear of life.

A Kuarter of the reportedreaction can be

con rmed by oral foodchallenge.

As many as a third of casesof anaphylactic shoc<

caused by food allergies.An estimated 00 fatal

cases were caused by foodallergies occur each year in

the nited &tates.


35/43

DIS) SSION

B c1 et a0!)are2u0 hist ry>ta1in3 inc0udin3 the use 2 2 d

diaries -y an e4"erienced a00er3ist can 2tenidenti2y sus"ect 2 ds!

E0i/inati n diets 2 00 &ed -y cha00en3es cans /eti/es c nfr/ the e4istence 2 a 2 d>

ass ciated adverse reacti n!

The 3 0d standard 2 r d cu/entin3 e4istence2 a 2 d a00er3y is d u-0e>-0ind "0ace- >

c ntr 00ed 2 d cha00en3e :DBC)F)?


36/43

DIS) SSION

+em


37/43

DIS) SSION

Meiger and Heller : The "reventi n 2 deve0 "/ent 2 I3E

/ediated 2 d a00er3ies a/ n3 hi3h>ris1 in2ant

has -een a0 n3 s u3ht 3 a0! The resu0t 2 severa0 0ar3e c0inica0 tria0 2 hi3h>

ris1 in2ant 2 00 &ed 2 r severa0 years su33estthat the deve0 "/ent 2 I3E /ediated 2 d

a00er3ies can -e de0ayed -ut n t "revented

The /aterna0 diet durin3 "re3nancy d es n tsee/ t -e a 2act r -ecause sensiti ati n d es

n t ccur in uter !


38/43

DIS) SSIONHattevig et al/ Meiger and

Heller : The av idance 2 c // n0y a00er3enics 2 d in

the in2ant diet durin3 the frst 2e& years 2 0i2e2ten de0ays the deve0 "/ent 2 2 d a00er3ies#-ut 2 d a00er3ies sti00 /ay deve0 " a2ter s 0id

2 d are intr duced!; ellm an and L or


39/43

DIS) SSION

&ampson :In a "r s"ective study 2 8


40/43

9ood allergy collection of symptoms thataDect many organs and body systems caused byfood allergies are $g6,mediated reactions/ cell,

mediated or both.

7he etiology glycoprotein with a molecularweight of 0 to -0


41/43

7he clinical symptoms of food allergyreaction usually aDecting the s


42/43

$n vitro eJamination eJamination of $g6/monoclonal antibodies/ histamine release by

basophils and mast cells release histamine byintestinal.

9ood provocation the gold standard for thediagnosis of food allergy.

%roved e?cient management is to avoid theoDending food

4 14+ &$1


43/43

Than1 y u

powerpoint alergy

Documents