1- Edema of oral mucosa after ingestion of certain fresh fruits and vegetables in patients with pollen allergies 2 - Inciting antigens destroyed by cooking 3 - Caused by cross-reactivity of antibodies to pollens 4 - Rarely progresses beyond the mouth
Diagnosis Food allergy is suspected when typical symptoms occur with the introduction of specific foods. 2.Pharmacologic activity of foods Other non-allergic mechanisms of food intolerance should be ruled out: 1.Compromised digestive or absorptive processes 3.Contamination with microbes or toxins
Seventy-five per cent of children with food allergy react only to a single food.
Children with allergic eosinophilic gastroenteritis are the exception, often reacting to multiple foods
Treatment and Prognosis. The only therapy proved effective for food allergy is an elimination diet . Most gastrointestinal manifestations resolve within several days , although some may take weeks (food-induced enteropathy ).
Re-lactation is an alternative when cow's milk allergy presents early .
Cont. About 50% of infants who experience proctocolitis while nursing improve with removal of cow's milk from the mother's diet. If the symptoms are severe enough (anemia and hypoproteinemia) decide to change in the infant's diet to a protein hydrolysate formula.
Eighty-five per cent of infants with non-IgE-mediated food hypersensitivity to milk proteins no longer have symptoms on food challenge by 3 yr of age.
Resolution of symptoms from cow's milk or soy protein hypersensitivity is common by 1 yr of age .
Cont. When milk is reintroduced, only a teaspoon or less should be offered at first and then increased progressively over a few days if tolerated Even older children and adults may lose their sensitivity to an offending food when it is eliminated from the diet for 1 to 2 yr
Jeffrey Hyams . Food Allergy (Food Hypersensitivity) .in Nelson textbook of pediatrics(19 th ed)chap318
Kokkonem J, Haapalabit M, Laurila K, et al: Cow's milk protein-sensitive enteropathy at school age. J Pediatr 2001;139:797-803.
Sampson HA, Anderson JA: Summary and recommendations: Classification of gastrointestinal manifestations due to immunologic reactions to foods in infants and young children. J Pediatr Gastroenterol Nutr 2000;30:S87
Sicherer SH, Noone SA, Koerner CB, et al: Hypoallergenicity and efficacy of an amino acid-based formula in children with cow's milk and multiple food hypersensitivities. J Pediatr 2001;138:688