ACAAI Meeting November 2013

[CMdeux]

So-- this meeting is going on right now--

The twitter feed for the meeting is here:

https://twitter.com/search?q=%23acaai


I thought this was a REALLY nice presentation, and I noticed that it had been picked up by the media:


http://www.acaai.org/allergist/news/New/Pages/DefiningAllergyFactfromFiction.aspx

In his presentation, Dr. Stukus outlined some of the greatest allergy myths, and explained why they are false.

    I'm Allergic to Artificial Dyes – There is no scientific evidence to support a link between exposure to artificial coloring and allergies. Controversy exists regarding evidence for artificial coloring and behavioral changes in children, as well as dyes causing chronic urticaria and asthma.
    I Cannot Have Vaccines Due to an Egg Allergy – Egg embryos are used to grow viruses for vaccines such as the flu, yellow fever and rabies shots. However, it's now safe to get the flu shot, which can help prevent serious illness.
    At-Home Blood Tests Reveal All You're Allergic To – These tests might be able to reveal sensitization, but being sensitized to a certain allergen, like milk, doesn't mean you're allergic. These sort of at-home screening tests are not reliable and can often lead to misinterpretation, diagnostic confusion and unnecessary dietary elimination.
    Highly Allergenic Foods Shouldn't be Given to Children until 12 Months of Age – For most children, there is no evidence to support avoidance of highly allergenic foods past four to six months of age. New evidence emerging shows that early introduction of highly allergenic foods may promote tolerance.
    I'm Allergic to Cats and Dogs, but Can Have a Hypoallergenic Breed – Unfortunately, there is no such thing as a truly hypoallergenic dog or cat. Allergens are released in saliva, sebaceous glands and perianal glands. It's not the fur people are allergic to. It is true that some breeds are more bothersome for allergy sufferers than others.
    I'm Allergic to Shellfish and Cannot Have Iodine Imaging – Radiologists and cardiologists often use iodinated contrast during CT scans and other procedures for better imaging. Since shellfish contain iodine, many physicians have linked a contrast reaction to a shellfish allergy. However, this is false, and a shellfish allergy has nothing to do with the reaction. In fact, iodine is not and cannot be an allergen as it found in the human body.
    I Can't have Bread, I'm Allergic to Gluten – You can have a gluten intolerance, but it's extremely rare to have a true allergy. Most allergic reactions to these foods stem from wheat. Many people self-label as having gluten allergy and avoid gluten without any medical indication.

With information being widespread online via social media portals, how do you know what to believe and what not to believe?

"If you think you may have an allergy, you should see a board-certified allergist for proper evaluation, testing, diagnosis and treatment," said Dr. Stukus. "Misdiagnosis and inappropriate treatment can be dangerous."

Unfortunately, the bit that HAS been picked up is "Gluten Allergy not real."     Which, um-- kind of misses the point, I think.  If you have celiac, or are one of those "rare" people with a wheat allergy, you DO need for people not to be telling you that you're just being a PITA.

[CMdeux]

OAS + ACE inhibition = anaphylaxis??  (wow.)

http://www.acaai.org/allergist/news/New/Pages/OralAllergySyndromeandHighBloodPressureMedicationscanCreateLethalCocktail.aspx

Oral allergy syndrome sufferers that take high blood pressure medications may experience extreme facial swelling and difficulty breathing the next time they bite into a juicy apple. When patients with oral allergy syndrome take angiotensin-converting enzyme (ACE) inhibitors for hypertension and congestive heart failure, they are at an increased risk for a life-threatening allergic reaction known as anaphylaxis, according to new research.

The case studies, being presented at the Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology (ACAAI), found use of ACE inhibitors can cause what is known as a "priming effect" in oral allergy syndrome sufferers.

"When a sufferer's allergies are primed and they come in contact with a particular allergen, they experience a more severe than normal reaction," said allergist Denisa Ferastraoaru, MD, ACAAI member and lead study author. "Symptoms can include extreme facial swelling (angioedema) and difficulty breathing, which can lead to death in some cases."

Pretty important stuff. 

[CMdeux]

"You Can have a Food Allergy and Eat it too"  (Oh my-- was really hoping that this was an unfortunate titling incident involving someone uneducated at AP or Reuters, but apparently not)

http://www.acaai.org/allergist/news/New/Pages/YoucanhaveaFoodAllergyandEatitToo.aspx

"Different parts of food may have different allergenicity," said presenter Sami Bahna, MD, allergist and ACAAI past president. "For example, someone with an egg allergy may be able to tolerate egg yolk but not the whites. And someone with a fruit allergy may be allergic to the seeds but not the pulp."

In his presentation, Dr. Bahna noted not only can certain parts of food be safe to eat for some food allergy sufferers, but there are some substitutes that can be eaten as well.

"Just because someone is allergic to cow's milk, doesn't mean they are allergic to milk from all other animals," said Dr. Bahna. "Some sufferers might have to avoid several foods, which can be difficult and cause malnutrition. But there are substitutes that can be eaten without any side effects."

Some food sensitivities may also predict other food allergies. Different types of fruits and fish can often have substantial cross-reactivity, meaning there may be several types that need to be avoided.

Rosaceae fruits, which include apple, apricot, almond, peach, pear, plum and strawberry, showcase this cross-reactivity. Crustaceans, such as shrimp and lobster, or molluscs like clam and squid can also have this cross-reactivity. But it's more unlikely that someone allergic to shrimp is also allergic to squid.

"While many food allergic individuals find they can eat certain parts of food or substitutes, this isn't a one size fits all approach," said Dr. Bahna. "Allergy manifests in everyone differently. If you have a food allergy, evaluation by a board-certified allergist can identify the exact foods that you should avoid and the substitute foods that you can safely eat."

While all technically TRUE, and all pretty important, it is SUPER unfortunate (IMO) that the money shot there, (bolded by me) is so far down the page.


This is another one that has been picked up by the media-- though luckily not that widely yet.

[CMdeux]

So what some of us have hypothesized for many years.... apparently really DOES seem to work:

http://www.acaai.org/allergist/news/New/Pages/TheGreatDisappearingActBoneMarrowReceiverCuredofAllergy.aspx

Not only can bone marrow transplants be life-saving for children with acute lymphocytic leukemia, they may also cure peanut allergies. According to research presented during the American College of Allergy, Asthma and Immunology's (ACAAI) Annual Scientific Meeting, a 10-year-old boy no longer had a peanut allergy after undergoing a bone marrow transplant.

"It has been reported that bone marrow and liver transplants can transfer peanut allergy from donor to recipient," said allergist Yong Luo, MD, Ph.D., ACAAI member and lead study author. "But our research found a rare case in which a transplant seems to have cured the recipient of their allergy."

At 15 months of age, researchers noted the child had been diagnosed with a peanut allergy after experiencing whole body hives and vomiting following peanut ingestion. At age 10, he underwent a bone marrow transplant for leukemia, from a donor with no known allergies. Soon after, the child seemed to no longer have an allergy to peanuts. Allergists confirmed with an oral food challenge, which should only be done in an allergist's office, where the child ate a small amount of peanut and showed no allergic reaction.

[LinksEtc]

"Best Food Allergy Tweets/Posts From 2013 ACAAI Meeting"
http://foodallergybitch.blogspot.com/2013/11/best-food-allergy-posts-from-2013-acaai.html