scholarly journals Successful management of extremely frequent hives in children with multiple food allergies with integrative traditional Chinese medicine therapy

2020 ◽  
Author(s):  
Fan Xiawen ◽  
Misu Paul ◽  
Tory McKnight ◽  
Song Park ◽  
Danna Chung ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Specific Ige ◽  
Food Allergies ◽  
Dramatic Improvement ◽  
Total Ige ◽  
Curative Therapy ◽  
Epinephrine Injection

Abstract BackgroundFood allergy is becoming increasingly common among the pediatric population. Despite strict avoidance of food allergens, a subgroup of sensitive individuals still develop frequent, persistent and difficult to treat hives (FPDTH) for which there is no curative therapy. Although these cases are rare, these patients are in most need of therapy.Case DescriptionThis is a retrospective review of 3 pediatric patients with highly sensitive food allergy who initially presented with hives daily or every other day, but achieved marked remission after traditional Chinese medicine (TCM) therapies. Patient 1 (P1) is a 5-year-old who had experienced 140 reactions in his lifetime. Reactions were mostly hives with 4 episodes of anaphylaxis. P1 had used Prednisone 20 times, had an Epinephrine injection 4 times and had 3 emergency room (ER) visits. Patient 2 (P2) is a 12-year-old who had experienced hives since age 3. Despite daily antihistamine use, P2 had > 730 reactions in his lifetime at the time of presentation including 2 episodes of anaphylaxis. He had been prescribed prednisone 4 times, an Epinephrine injection 2 times and had 1 ER visit. Patient 3 (P3) is a 20-month-old girl who had experienced > 120 reactions including 1 episode of anaphylaxis. She was on daily desonide and frequently used and antihistamine, yet still had required a course of prednisone once, an Epinephrine injection once and had 1 ER visit to manage her reaction. After presenting to our clinic, patients received internal and external TCM treatments, including herbal bath and creams (Remedy A-D) as basic remedies to reduce food reactions, including but not limited to frequent hives. Within 7–9 months of TCM treatment, remarkably all patients had complete remission of atopic symotoms. All three patients also experienced improvement in other conditions including food intolerance, diarrhea, anxiety, eczema, environmental allergies. After 1 year of treatment, all three patients had reductions in food-specific IgE levels that had been previously elevated, and additionally, P1 and P3, who initially had high total IgE levels, experienced marked decrease in total IgE levels as well. All three patients continued to introduce foods into their diet that they previously had reactions to, and all 3 patients remain symptom-free.ConclusionsThree pediatric patients with known history of multiple food sensitivities and physician diagnosed food allergies that presented with FPDTH underwent TCM regimen and experienced dramatic improvement in symptoms and reduction in their IgE levels. This regimen appears to be effective in FPDTH population although further study in a controlled clinical setting is required.

scholarly journals Case Series: Refractory Cases of Hyper-serum IgE Achieve Transformative Decrease by TCM Therapy

2021 ◽  
Author(s):  
Johnathan Neshiwat ◽  
Tory Mcknight ◽  
Serife Uzun ◽  
Paul Ehrlich ◽  
Danna Chung ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Pediatric Population ◽  
Case Series ◽  
Food Allergies ◽  
Future Research ◽  
Hypersensitivity Reactions ◽  
Safe Alternative ◽  
Serum Ige ◽  
Ige Mediated

Abstract Background:Chronic conditions from IgE-mediated hypersensitivity reactions affect over 150 million Americans, but affordable and effective treatment options remain largely unavailable to the pediatric population. Traditional Chinese medicine has been shown to reduce IgE levels in refractory cases of hyper-serum IgE and have transformative effects in pediatric patients with chronic allergic inflammation.Presentation:Here we present ten patients with chronic atopic conditions and refractory hyper-serum IgE who were treated with TCM therapy. The patients had at least two atopic conditions as well as multiple allergic sensitivities to foods and environmental allergens: all of the patients presented with food allergies (FA) and atopic dermatitis (AD), 60% of patients presented with an environmental allergy (EA), 40% of patients presented with asthma (AS), 10% had celiac disease (Celiac), and 10% had eosinophilic esophagitis (EoE). All of the affected patients had IgE levels greater than 5,000kIU/L (normal =300kIU/L) prior to treatment. None of the patients had an IgE of greater than 5,000kIUL after treatment. We treated 10 children with IgE-mediated hypersensitivity reactions using topical and oral TCM and found an average reduction of 3,723kIU/L IgE per patient (p=0.01) or 79%. Conclusion:We present a ten-patient case series on the effective lowering of hyper-serum IgE using Traditional Chinese Medicine in otherwise refractory pediatric cases of chronic atopic inflammation. TCM is an affordable and safe alternative for chronic atopic conditions compounded with hyper-serum IgE. Future research via random controlled trials should be used to test the efficacy of TCM.

Is There Benefit in Identifying Asthma Triggers During an Exacerbation?

2019 ◽  
Vol 59 (2) ◽  
pp. 142-147
Author(s):  
Pushpom James ◽  
Anna Cornish ◽  
Kaylan Brady ◽  
Jennifer Morrison ◽  
Yvonne Giunta ◽  
...  
Keyword(s):  
Prospective Study ◽  
Asthma Control ◽  
Asthma Exacerbation ◽  
Pediatric Patients ◽  
Objective Assessment ◽  
Specific Ige ◽  
Total Ige ◽  
Symptom Resolution ◽  
A Prospective Study ◽  
Asthma Triggers

Introduction. Allergen-specific IgE (sIgE) testing provides an objective assessment of sensitization to an allergen. Goal. To identify the time when serum measurements of sIgE would be most sensitive. Methods. This was a prospective study conducted between September 1, 2015, and February 25, 2019. Subjects ≥5 and ≤18 years of age, seen in the ED or admitted with an asthma exacerbation, were tested for total IgE and 8 perennial sIgE levels. Subjects with elevated sIgE were tested again after symptom resolution. Results. A total of 104 subjects were enrolled; 50 subjects were eligible for inclusion in the analysis. There were statistically significant differences between the visits for all sIgE, except Alternaria alternatum. Conclusions. In pediatric patients, serum sIgE levels measured during an asthma exacerbation were elevated compared with when their asthma was in better control. sIgE testing during an asthma exacerbation may help identify asthma triggers, mitigate exposure, and hence improve asthma control.

Prevalence of Elevated Total IgE and Food Allergies in a Consecutive Series of ENT Pediatric Patients

2006 ◽  
Vol 134 (4) ◽  
pp. 578-580 ◽  
Author(s):  
Shazia Bhombal ◽  
Marcella R. Bothwell ◽  
S. M. Bauer
Keyword(s):  
Pediatric Patients ◽  
Food Allergies ◽  
Consecutive Series ◽  
Total Ige

Sacroiliac joint pain in the pediatric population

2012 ◽  
Vol 9 (6) ◽  
pp. 602-607 ◽  
Author(s):  
Ivan Stoev ◽  
Alexander K. Powers ◽  
Joan A. Puglisi ◽  
Rebecca Munro ◽  
Jeffrey R. Leonard
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Response To Treatment ◽  
Home Exercise ◽  
Dramatic Improvement ◽  
Minor Trauma ◽  
Low Back ◽  
Si Joint

Object The sacroiliac (SI) joint can be a pain generator in 13%–27% of cases of back pain in adults. These numbers are largely unknown for the pediatric population. In children and especially girls, development of the pelvic girdle makes the SI joint prone to misalignment. Young athletes sustain repeated stress on their SI joints, and sometimes even minor trauma can result in lasting pain that mimics radiculopathy. The authors present a series of 48 pediatric patients who were evaluated for low-back pain and were found to have SI joint misalignment as the cause of their symptoms. They were treated with a simple maneuver described in this paper that realigned their SI joint and provided significant improvement of symptoms. Methods A retrospective review of the electronic records identified 48 patients who were referred with primary complaints of low-back pain and were determined to have SI joint misalignment during bedside examination maneuvers described here. Three patients did not have a record of their response to treatment and were excluded. Patients were evaluated by a physical therapist and had the realignment procedure performed on the day of initial consultation. The authors collected data regarding the immediate effect of the procedure, as well as the duration of pain relief at follow-up visits. Results Eighty percent of patients experienced dramatic improvement in symptoms that had a lasting effect after the initial treatment. The majority of them were given a home exercise program, and only 2 of the 36 patients who experienced significant relief had to be treated again. Fifty-three percent of all patients had immediate and complete resolution of symptoms. Three of the 48 patients had missing data from the medical records and were excluded from computations. Conclusions Back pain is multifactorial, and the authors' data demonstrate the potential importance of SI joint pathology. Although the technique described here for treatment of misaligned SI joints in the pediatric patients is not effective in all, the authors have observed significant improvement in 80% of cases. Often it is difficult to determine the exact cause of back pain, but when the SI joint is suspected as the primary pathology, the authors have described a simple and effective bedside treatment that should be attempted prior to the initiation of further testing and surgery.

scholarly journals Clinical manifestations of atopy in children up to two years of age

2011 ◽  
Vol 68 (8) ◽  
pp. 690-695 ◽  
Author(s):  
Nevenka Ilic ◽  
Vesna Velickovic ◽  
Dragoljub Djokic ◽  
Nebojsa Rankovic ◽  
Gordana Kostic ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Atopic Dermatitis ◽  
Clinical Manifestations ◽  
Allergic Diseases ◽  
Developed Countries ◽  
Specific Ige ◽  
Food Allergies ◽  
Atopic Diseases ◽  
Ige Antibodies ◽  
Total Ige

Background/Aim. Atopic diseases such as atopic dermatitis, allergic rhinitis and asthma have had increased prevalence during the past decade and nowadays occur in every third child in developed countries. The aim of the study was to determine frequency and type of atopic diseases at the age of two, as well as the importance the total IgE antibodies concentrations have in diagnosis and prognosis of the disease. Methods. The study involved 175 children up to two years of age. Allergy-like symptoms were found after surveying their parents and pediatric medical records. Using the fluorescence immunossay (FIA) method, total IgE antibodies concentrations and specific IgE antibodies (Phadiatop infant) were determined on an Immunocap 100 Dyagnostic System. Results. One or more allergy-like symptoms accounted for 57.7% of findings in children under the age of two, whilst in 19.4% the existence of IgE-related allergic diseases was found. Atopic diseases usually have clinical manifestations of atopic dermatitis (11.4%), IgE-bound wheezing/asthma (10.8%) and food allergies (7.4%), and to much lesser extent those of allergic rhinitis (3.4%) and urticaria (1.7%). The significantly higher total IgE antibodies concentrations were found in children with allergy-like symptoms (p < 0.0005) (cut-off 15.15 kU/L, sensitivity 76.5% specificity 71.6%). Conclusion. Almost 20% of two-year-old children have any of clinically manifested allergic diseases, with atopic dermatitis and IgE wheeze/asthma being predominant. The higher total IgE antibodies concentration is a good marker for sensitization in children with allergy-like symptoms.

scholarly journals Characteristics and Treatment of Anaphylaxis in Children Visiting a Pediatric Emergency Department in Korea

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Won Seok Lee ◽  
Jaewoo An ◽  
Young-Ho Jung ◽  
Hye Mi Jee ◽  
Kyu-Young Chae ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pediatric Patients ◽  
Pediatric Emergency ◽  
Food Allergies ◽  
Study Patient ◽  
Pediatric Emergency Department ◽  
Laboratory Findings ◽  
Korean Children ◽  
Epinephrine Injection ◽  
Tryptase Level

Anaphylaxis is a serious life-threatening allergic disease in children. This study is aimed at determining the characteristics of pediatric patients who experienced anaphylaxis along with treatments administered in order to determine the usefulness of tryptase level assessment as a marker of anaphylaxis in Korean children. A total of 107 patients who were diagnosed with anaphylaxis in a single pediatric emergency center over a 3-year period were included in the study. Patient clinical characteristics, symptoms, signs, allergy history, trigger factors, treatments, and laboratory findings, including serum tryptase levels, were included in the analysis. Food allergies (39.3%) were the most commonly reported patient allergic history, and 58 patients (54.2%) were triggered by food. Among this group, nuts and milk exposure were the most common, affecting 15 patients (25.9%). History of anaphylaxis and asthma were more common in severe anaphylaxis compared to mild or moderate anaphylaxis cases. Epinephrine intramuscular injection was administrated to 76 patients (71.0%), and a self-injectable epinephrine was prescribed to 18 patients (16.8%). The median tryptase level was 4.80 ng/mL (range: 2.70–10.40) which was lower than the 11.4 ng/mL value commonly documented for standard evaluation in adults with anaphylaxis. The most common cause of pediatric anaphylaxis was food including nuts and milk. The rate of epinephrine injection was relatively high in our pediatric emergency department. The median tryptase level associated with anaphylaxis reactions in children was lower than 11.4 ng/mL. Further studies are needed to help improve diagnostic times and treatment accuracy in pediatric patients who develop anaphylaxis.

scholarly journals Successful sublingual immunotherapy for severe egg allergy in children: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Nagatoshi Sagara ◽  
Satoshi Fujita ◽  
Ryohei Suzuki ◽  
Akiko Aota ◽  
Kenichi Akashi ◽  
...  
Keyword(s):  
Sublingual Immunotherapy ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Egg Allergy ◽  
Efficacy And Safety ◽  
Safety Issues ◽  
Epinephrine Injection ◽  
Promising Treatment ◽  
Whole Egg

Abstract Background Egg allergy is one of the most common food allergies in children. To date, oral immunotherapy (OIT) has been considered as a promising treatment option for egg allergy. However, safety issues remain concerning severe adverse events requiring epinephrine injection. Hence, establishing a safer method to treat egg allergy would be beneficial. We report here two children with egg allergy who were safely treated with sublingual immunotherapy (SLIT) before transitioning to OIT. Case presentation Patient 1 was a 7-year-old girl and Patient 2 was a 5-year-old girl. Although OIT for egg had been attempted in both patients, severe anaphylactic symptoms were induced by ingesting only 0.1 g of heated whole egg. Therefore, SLIT was conducted with aqueous suspensions consisting of water and heated whole egg powder. Suspensions were administered sublingually, kept in the mouth for 2 min, and spat out immediately thereafter. SLIT was continued for 7 months for Patient 1 and 8 months for Patient 2 due to the exploratory character of the study. Afterwards, the patients successfully transferred to low-dose OIT with 1 g of heated whole egg (≒170 mg of egg protein) daily, and are continuing the therapy as of June 2020. As for adverse reactions, Patient 1 expressed oral cavity itchiness once at the beginning of SLIT. Patient 2 had no adverse reaction. The levels of antigen-specific IgE decreased in both patients after SLIT, and further decreased after switching to OIT. Conclusions Few clinical studies have evaluated the efficacy and safety of SLIT for egg allergy. Although the treatment was conducted in only two patients, our results have shown that SLIT is a promising treatment procedure for egg allergy. Further clinical trials will be needed to additionally assess the efficacy and safety of SLIT in children with food allergy.

Allergic Reactions to Food Proteins

2011 ◽  
Vol 81 (23) ◽  
pp. 173-180 ◽  
Author(s):  
Barbara K. Ballmer-Weber
Keyword(s):  
Food Allergies ◽  
Allergic Reactions ◽  
Allergenic Food ◽  
Processed Foods ◽  
Legal Regulations ◽  
Pollen Allergens ◽  
Curative Therapy ◽  
Novel Foods ◽  
Allergenic Proteins ◽  
Adolescents And Adults

Four to eight percent of the population are estimated to be food-allergic. Most food allergies in adolescents and adults are acquired on the basis of cross-reaction to pollen allergens. Theses allergens are ubiquitous in the plant kingdom. Therefore pollen-allergic patients might acquire a multitude of different plant food allergies, and even react to novel foods to which they have never previously been exposed. A curative therapy for food allergy does not yet exist. Food-allergic patients have to rely on strict avoidance diets, The widespread use of industrially processed foods poses a general problem for food-allergic patients. Although the most frequent allergens must be declared openly in the list of ingredients, involuntary contamination with allergy-provoking compounds can occur. The precautionary labelling “may contain” is sometimes applied even if the chance of contamination is very low; on the other hand, foods not declared to contain possible traces of allergenic components may actually contain relevant amounts of allergenic proteins. Switzerland is the only country in Europe with legal regulations on contamination by allergenic food; however, the allowance of 1 g/kg is too high to protect a relevant proportion of food-allergic individuals.

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