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Peds Allergy


Atopy is ____ mediated IgE
Most common of the atopic disorders allergic rhinitis
allergic rhinitis is rare in: infants <6 months
allergic rhinitis: Dx by: Clinical; allergy prick skin tests-; serum RAST tests; nasal smear eosinophilia
allergic rhinitis: Tx includes: allergen avoidance, pharm; immunotherapy
atopic dermatitis: labs Allergy skin tests; ImmunoCAP to specific antigens; Skin cx; Double blind food challenge
Gold standard to dx food allergies double-blind food challenge
atopic dermatitis has a strong association with ____ allergies food allergies
Atopic dermatitis: Clinical features (Major) Pruritis; rash distribution varies; Relapsing nature; h/o other allergic sx
Atopic dermatitis: acute lesions poorly defined papules, patches and plaques; +/- scale; edema, erythema and excoriation
Atopic dermatitis: chronic lesions skin thickening (lichenification) , hyperpigmentation
Atopic dermatitis: Clinical features (minor) xerosis; hyperlinear palms; infraorbital shiners (Dennie lines); food intolerances; secondary cutaneous infxn )SA, MRSA, HSV); wool intolerance; increased itch with sweating
allergic rhinitis DDx sinusitis; rhinitis medicamentosa;; local (polyp, deviated septum, adenoid, foreign body); vasomotor rhinitis
atopic dermatitis DDx seborrhea; contact dermatitis (nickel); scabies
allergic rhinitis DDx sinusitis (HA, purulent d/c, PND); rhinitis medicamentosa; local (polyps, deviated, FB); vasomotor
Seasonal allergies usu present at age: >3 yrs
Six foods cause 90% of food allergy in children: Milk, egg, peanut, wheat, soy, tree nuts
ImmunoCap test: No proven value of food specific: IgG levels
Food allergy: tx eliminate offending food; pt education; Medic Alert bracelet; emergency plan; Epi Pen
Which allergies usually resolve by 10-12 yo & which persist? Milk, egg, wheat, soy resolve; tree nuts, peanut, & seafood persist into adulthood
Food anaphylaxis 150 deaths/year; peanut, tree nut, shellfish; biphasic rxn; lack of cutaneous sx
Food allergies: effectiveness not established for: breastfeeding >6 mos; maternal diet restrictions; delayed intro of allergic foods; hypoallergenic formulas
Oral allergy syndrome: usually with: fresh fruits/veg; cross-reactive proteins in pollen & food
Created by: Abarnard