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Query: UMLS:C0042109 (urticaria)
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Case histories are analyzed of 1565 hay fever patients first attending an allergy unit. The mean age of the test persons was 19.5 years. 40% were in the age group 5 to 15 years. The sex distribution showed a slight but statistically significant prevalence of males (56.6%). 56.8% had a positive family history of allergies and 44.2% had other allergic conditions such as atopic dermatitis (31.6%), perennial rhinitis and perennial asthma (19% each), urticaria, food allergy and drug allergy (5% each) and insect sting allergy (3%). A clear cut peak both for rhinitis and for asthmatic symptoms %30.5% and 20.2% respectively) was found in the age group 5--9 years. Up to the 14th year the symptoms of pollen allergy were already exhibited by 68.5% of the patients. 97% of the pollen allergics suffered from rhinitis, 95% from conjunctivitis, 40% from bronchial asthma and another 20% from tracheobronchitis or asthmatic bronchitis. As additional symptoms of pollen allergy due to haematogenous spread of the pollen antigens we observed a seasonal form of atopic dermatitis in 3%, a seasonal urticaria or angioedema in 3.5%, migraine in 6.3% and arthralgia, gastro-intestinal troubles and fever in fewer than 1% each. Almost 98% of the patients were sensitized to grass or cereal pollens. However, only 18% suffered from an isolated grass pollinosis (summer hay fever). The other patients were additionally clinically sensitized by other pollens with different blossoming periods, i.e. 35% by three pollens responsible for the so-called spring pollinosis, and 50% by weeds (plantain, nettle, mugwort) the cause of late summer pollinosis. Only 13 patients suffered from an isolated spring pollinosis (hazel, alder, birch, willow). In 14 patients (not quite 1%) with a clear-cut history and clinical symptoms of pollinosis, all the skin tests were negative. In these cases the sensitization was probably restricted to the respiratory tract. Despite the new in-vitro methods such as the RAST, carefully performed skin tests linked to a knowledge of the pollen calendars of the region and the allergological history remain the most reliable and cheapest procedure for the specific diagnosis of pollen allergy.
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PMID:[Pollionosis: I. Findings on the clinical aspects and the pollen spectrum in 1565 pollen-sensitive patients]. 49 10

In this review I have described the pathophysiology of allergic disorders of the gastrointestinal tract. Situations where the intestine cannot be a complete barrier to foreign allergens and antigens were discussed and etiological factors of gastrointestinal allergy were detailed. Clinical features of gastrointestinal allergy include diarrhea, vomiting, abdominal pain and colic, intestinal hemorrhage and malabsorption as well as symptoms and signs outside the gastrointestinal tract such as chronic rhinitis and asthma in the respiratory system, urticaria, angioedema and eczema as dermatological signs, headache, insomnia, hyperkinesis as central nervous system manifestations, failure to thrive and anaphylaxis as constitutional reactions. Milk allergy was discussed as an example of food allergy. Immunology of the gastrointestinal tract was presented, with examples of four types of hypersensitivity reactions, and gastrointestinal disturbances of immunodeficiency disorders and syndromes were named. Lastly, the autoimmune mechanism and the gut were described, with particular discussion of ulcerative colitis as an example of an autoimmune disease.
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PMID:The intestine in allergic diseases. 78 84

There is a wide variety of criteria in regard to the etiology of atopic dermatitis of neurodermitis. The allergic factor may play a very important role in its etiology. There is neither a general agreement on the importance of food allergy in this regard. Broadly considered, these patients may evoke intense positive reactions to intradermal tests to food and inhalative allergens, nevertheless it will be possible to establish that the lesions appear or disappear after the exposure of suppression of the antigens which evoked the positive reaction. On this basis, many dermatologists deny the allergic etiology in atopic dermatitis, even though in most instances no food skin tests are performed. In this study, 110 patients, both children and adults of both sexes, suffering from atopic dermatitis are investigated. The onset in most of the cases is before the age of six months, following the ages between 1-10 years; the groups between 6 months and one year, and 10-20 years followed a descending order per decade until 70 years. 60.9% of the cases showed food allergy to one or more food items. In 39% of the cases, no food allergy was found. The food-stuffs more commonly involved were: milk (37.7%), egg (26.3%) and fish (20.9%), followed by coca, wheat flour, seafood, fruits, vegetables and meat. A remission of the reaction followed the suppression of the allergen. Intestinal parasitosis is evaluated in relation to atopic dermatitis. 30.9% of the 110 cases were affected with intestinal parasitosis, being the most common the flagelates (lamblias), protozoa (amoeba) and nematodes (ascaris, tricocephalus and oxijrus). Finally, a concurrence is found between atopic dermatitis and other allergic diseases in 81 cases (73.6%), being bronchial asthma and asthmatic bronchitis the most frequent, and allergic rhinitis, urticaria and Quincke's edema less frequent.
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PMID:[Etiopathogenesis of atopic dermatitis]. 118 Feb 2

We have studied 50 children suspected to have food allergy. Their clinical diagnoses included the following: digestive trouble (prolonged diarrhoea or vomiting), abdominal pain, repetitive urticaria, angioneurotic edema, eczema. The aim of thie study has been to value the results obtained with the hemagglutination test according to Boyden, comparing them with skin tests carried out through intradermal techniques. 113 hemagglutination and skin tests with varying foods have been carried out. Nearly all the children have been tested with milk, white and yolk of egg, the most suspected foods, and also other foods depending on the data found through anamnesis. With milk (47 cases) we have obtained positivity in 12 hemagglutination tests, and in 3 skin tests. With egg (41 cases) the hemagglutination test has been positive in 14 cases, and the skin test in 5 cases. Conjunctly in the 113 cases we have obtained positive hemagglutination test in 44 cases, and positive skin test in 14 cases. In 65 cases both tests have been negative. This fact points to the necessity to realize other diagnostic tests, as well the possibility that these children have no allergic disease. Summarizing, these results support the superior value of the hemagglutination Boyden test in comparison with the skin test as diagnosic proof in food allergy.
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PMID:[Hemagglutination test and the diagnosis of food allergy]. 124 48

IgE levels in faecal extracts (Copro-IgE levels) were investigated in food allergy (FA) patients before and after the challenge test administration of food allergens. IgE levels were measured by time-resolved fluoroimmunometric assay. In addition, the effects of administration of oral sodium cromoglycate (SCG) on the Copro-IgE levels were studied. Copro-IgE levels in patients with FA, who were placed on an elimination diet, did not differ from those of healthy children. After a challenge test immediate symptoms of urticaria and wheezing were observed in all FA patients. Copro-IgE levels in each patient increased markedly within 24 h of the challenge test. Moreover, FA patients treated orally with SCG showed neither the increase in Copro-IgE levels nor any remarkable symptoms after the challenge. Our results suggest that the increased Copro-IgE levels may be a specific consequence of the local immune response to food allergen stimulation in the gut mucosa.
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PMID:IgE levels in faecal extracts of patients with food allergy. 128 67

To evaluate humoral (IgE antibodies) and clinical (positive challenge test) soy hypersensitivity prevalence, we studied 317 children (271 boys and 100 girls) with a median age of 5 months (range 1-120) who visited the Division of Allergy and Clinical Immunology of the Pediatric Department of the University of Roma "La Sapienza" because of histories and symptoms suggestive of food allergy. Atopic dermatitis (AD) was present in 247/317 children (78%), diarrhea in 19 (6%), urticaria in 22 (7%), and rhinitis and/or asthma in 29 (9%). All children underwent diagnostic procedures including family and personal history, physical examination, PRIST, and RAST to cows milk (CM), egg, wheat, soy, and Dermatophagoides pteronyssinus (Dpt). Open challenge tests to soy were performed in the hospital under observation and with emergency equipment at hand. The prevalence of humoral sensitization to CM was 54%, to egg 46%, to Dpt 35%, to wheat 24%, and to soy 22%. Only five children had IgE only to soy; six to soy and egg; and 58 to soy, CM, and egg. Only ten children (3%) had positive challenge to soy and only five of them had IgE to soy. RAST had a sensitivity of 0.69, a specificity of 0.83, a negative predictive value of 0.77, and a positive predictive value of only 0.06.
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PMID:Soy hypersensitivity in children with food allergy. 138 Jul 84

A comparative study was made of three in vivo and in vitro diagnostic methods for food allergy: Fx5 multitest (Pharmacia); Measurement of specific IgE CAP (Pharmacia); Skin tests (Prick Tests). 20 patients, from 3 to 71 years (mean 24.4 years), were selected by clinical suggestion (asthma, rhinitis, atopic dermatitis, urticaria and/or Quincke's oedema). The Fx5 test used six food allergens: wheat, egg, cow's milk, soya, peanut and fish. The Cap Rast for each substance was evaluated, as was Fx5, by a radio-immunological method. The Prick Tests made with the six allergens used were considered to be positive when the diameter of the weal was greater than that produced by a reference test with histamine. The results were considered as a comparison between Fx5 and Cap Rast to each of the foods, between Fx5 and prick Test with five foods and finally between CAP RAST and Prick Test. Correlation Fx5--Cap rast was better and more useful in the diagnosis of food allergy than skin tests.
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PMID:[Multitest Fx5 in food allergy]. 138 58

Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are entirely due to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may either have a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time. The most common allergens (substances causing allergy) are grass and tree pollens, the house dust mite, products from pets and other animals, agents encountered in industry, wasp and bee venom, drugs, and certain foods. Food allergy presents a particularly difficult problem. Some individuals who react to food suffer from true food allergy but in others there is no evidence of an alteration in the immune system. Here the term 'food intolerance' is preferable. Conventional doctors treat allergy by allergen avoidance--where this is possible--and drugs that relieve symptoms. In a few selected cases, in which other methods have failed, immunotherapy (desensitisation or hyposensitisation) is recommended. Patients who consult practitioners of alternative allergy often do so because they are dissatisfied with the conventional approach to diagnosis and treatment, and sometimes because they have conditions which conventional doctors do not accept as having an allergic basis. There is a very wide range of alternative approaches to allergy, including the methods used by clinical ecologists, acupuncturists and homoeopathists. Hypnosis may have a small role to play in asthma, and similar claims for acupuncture need to be evaluated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Allergy: conventional and alternative concepts. Summary of a report of the Royal College of Physicians Committee on Clinical Immunology and Allergy. 140 18

Allergy is an exaggerated response of the immune system to external substances. It plays a role in a wide range of diseases. In some, such as summer hayfever, the symptoms are due entirely to allergy. In other conditions, particularly asthma, eczema and urticaria, allergy plays a part in some patients but not all. In these situations, allergy may have either a major role or provide just one of many triggers. In an individual patient's illness, the importance of allergy may change with time. The most common allergens (substances causing allergy) are grass and tree pollens, the house dust mite, products from pets and other animals, agents encountered in industry, wasp and bee venom, drugs, and certain foods. Food allergy presents a particularly difficult problem. Some individuals who react to food suffer from food allergy in its strict sense but in others there is no evidence of an alteration in the immune system. Here the term 'food intolerance' is preferable. Conventional doctors treat allergy by allergen avoidance--where this is possible--and drugs that relieve symptoms. In a few selected cases, in which other methods have failed, immunotherapy (desensitisation or hyposensitisation) is recommended. Although patients who consult practitioners of alternative allergy may do so by preference, it is often also because they are dissatisfied with the conventional approach to diagnosis and treatment, or because they have conditions which conventional doctors do not accept as having an allergic basis. There is a very wide range of alternative approaches to allergy, including the methods used by clinical ecologists and other treatments such as acupuncture and homoeopathy. Hypnosis may have a small role to play in helping the asthmatic and similar effects have been suggested for acupuncture. Furthermore, it is likely that there are still many active ingredients in medicinal plants used by herbalists but these need to be clearly identified and purified before their usefulness can be evaluated properly. Apart from these situations, we have yet to be convinced by substantial evidence that any of the other alternative methods of diagnosing or treating allergic disease are of proven value. There have, however, been many false and misleading claims and serious harm may be caused by misdiagnosis or delays in appropriate treatment. The public should be warned against costly methods of diagnosis and treatment which have not been validated.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Allergy. Conventional and alternative concepts. A report of the Royal College of Physicians Committee on Clinical Immunology and Allergy. 142 46

This article describes the terms used for the various syndromes and diseases associated with reactions to foods; it outlines the principal types of food intolerance encountered in children, with particular emphasis on those caused by immune-mediated reactions of immediate hypersensitivity. Terms defined include food intolerance or food sensitivity; food allergy or food hypersensitivity; psychologically based food reactions (food aversions); and psychosocial and neurologic dysfunction. The spectrum of food sensitivity is considerable, and diagnosis is generally based on the monitoring of effects of exclusion diets and provocation tests, after appropriate objective measures are first selected. In children, manifestations of IgE-mediated food allergy (often in association with other immune mechanisms) include self-limiting and immediate reactions (e.g., urticaria, wheeze) and chronic diseases (food-sensitive enteropathies, eczema). Controversial and unresolved issues exist with some other conditions, including eosinophilic gastroenteritis, occult gastrointestinal bleeding, protein-losing enteropathy, and attention deficit disorder with hyperactivity. New methods for clinical investigation of gastrointestinal tract function and intestinal immune reactions are required to assess the relevance of foods in these conditions.
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PMID:Definitions and diagnosis of food intolerance and food allergy: consensus and controversy. 144 36


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