food%20allergy%20(pediatric)
FOOD ALLERGY (PEDIATRIC)
Food allergy is an adverse reaction due to a specific immune response occurring reproducibly upon exposure to certain foods. It occurs minutes to hours after food consumption.
Immunological mechanisms can be IgE mediated, non-IgE mediated or mixed IgE and non-IgE mediated.
It may be life-threatening and is the most common cause of anaphylaxis in children.
It should be differentiated from food intolerance in which adverse reactions from exposure to food arise from non-immunological mechanisms.

Introduction

  • May be life-threatening & is the most common cause of anaphylaxis in children
  • Should be differentiated from food intolerance, in which adverse reactions from exposure to food arise from non-immunological mechanisms

Definition

  • An adverse reaction due to a specific immune response occurring reproducibly upon exposure to certain foods

Etiology

Immunological mechanisms:

  • IgE mediated (eg oral allergy syndrome)
  • Non-IgE mediated (eg food protein-induced enteropathy, celiac disease) - may be caused by several chronic diseases
  • Mixed IgE & non-IgE mediated (eg eosinophilic gastroenteritis)

Signs and Symptoms

  • Occurs minutes to hours after food consumption
  • Cutaneous: Flushing, erythema, pruritus, urticaria, angioedema, morbiliform eruption, eczematous rash
  • Ocular: Pruritus, conjunctival erythema, tearing, periorbital edema
  • Respiratory: Sneezing, rhinorrhea, nasal congestion, pruritus, dry cough, laryngeal edema, hoarseness, dyspnea, wheezing, chest tightness, intercostal retractions, accessory muscle use
  • Gastrointestinal: Angioedema of lips, tongue, or palate, oral pruritus, tongue swelling, nausea & vomiting, reflux, abdominal pain, diarrhea, hematochezia, irritability & food refusal w/ wt loss in young children
  • Cardiovascular: Hypotension, dizziness, tachycardia (sometimes bradycardia in anaphylaxis), fainting, loss of consciousness
  • Miscellaneous: Uterine contractions, vertigo, hemiparesis (in adults), sense of “impending doom”
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