Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge.
نویسندگان
چکیده
OBJECTIVES To provide a review of the literature and discuss the clinical, pathophysiologic, diagnostic, and therapeutic challenges of oral allergy syndrome (OAS). DATA SOURCES English-language publications on OAS (and pollen-food allergy syndrome) were identified through MEDLINE and through the reference lists of each identified article and review. STUDY SELECTION Articles pertaining to OAS with respect to its varied clinical presentation, underlying pathophysiology, available and investigational diagnostic testing, and evidence-based treatment options were selected. RESULTS OAS occurs in patients with a prior cross-reactive aeroallergen sensitization and clinically presents with initial oralpharyngeal symptoms after ingestion of a triggering fruit or vegetable. Although controversial, these symptoms may progress to systemic symptoms outside the gastrointestinal tract in 8.7% of patients and anaphylactic shock in 1.7%. OAS's underlying pathophysiology may play a role in clinical presentation and outcome, depending on whether the cross-reactive protein is a heat-labile PR-10 protein, a partially labile profilin, or a relatively heat-stable lipid transfer protein. Diagnostic testing is variable based on the underlying food tested, but fresh food skin prick test typically has the highest sensitivity. Treatment centers on avoidance and the consideration of self-injectable epinephrine. Because of its relationship with a cross-reactive aeroallergen sensitization, subcutaneous immunotherapy and sublingual immunotherapy have also been therapeutically tried with mixed results. CONCLUSION OAS is a challenging diagnosis to the practicing allergist because of its many clinical, diagnostic, and therapeutic considerations. Understanding these challenges and their underlying mechanisms can facilitate a knowledgeable approach to treating an oral allergy patient.
منابع مشابه
Clinical Protests Food Allergy in Children
The best recognized intestinal manifestation of food allergy is food allergic (food-sensitive) enteropathy. The feature of enteropathy may include lymphocyte and plasma cell infiltration, epithelial abnormality, or crypt hyperplastic villous atrophy, and impairing absorption, enterophaty continues while the food remains in the diet, remitting on an exclusion diet, and usually recurring on food ...
متن کاملAtopy patch test for the diagnosis of food protein-induced enterocolitis syndrome.
Food protein-induced enterocolitis syndrome (FPIES) is thought to be a non-IgE mediated food allergy syndrome. Affected infants typically demonstrate gastrointestinal symptoms after hours after ingestion of the offending food. Traditional allergy testing is not useful for this disorder because tests for food specific IgE are routinely negative. A diagnostic oral food challenge (OFC) is the only...
متن کاملStudy of food allergy on Spanish population
Background: The aim of the study was to investigate the prevalence of food allergy in patients referred to our Allergy Unit and to evaluate the diagnostic methods used. Methods: We selected 674 patients referred to the Allergy Unit of our hospital from May 2002 to October 2004. The prevalence of symptoms was determined by a standardized questionnaire, prick-prick test, and serum specific IgE. I...
متن کاملAtypical Omenn Syndrome Due to RAG2 Gene Mutation, a Case Report
Severe Combined Immunodeficiency (SCID), characterized by a profound decrease in both the number and function of T cells, is related to more than 20 different mutations. Recombination-activating gene (RAG) 1 and 2 seem to be two of the most common forms presenting with various manifestations, including typical SCID, Omenn syndrome (OS), atypical SCID (AS), or delayed onset combined immunodefici...
متن کاملMelkersson-Rosenthal syndrome: Appropriate response to the combination treatment with intralesional triamcinolone injection and oral azithromycin
Melkersson-Rosenthal syndrome is an uncommon disorder which is presented by a triad of lip swelling, facial nerve palsy, and a fissured tongue. A number of treatments have been reported for this syndrome with variable outcomes. We have reported a 38-year-old female patient with lower lip swelling and a fissured tongue on clinical examination. She was also suffering from facial nerve paralysis s...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
دوره 104 2 شماره
صفحات -
تاریخ انتشار 2010