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Studies have shown that it is useful to screen such patients for mastocytosis. This is a relatively rare condition that results in the overgrowth of the allergic "mast cells" in the body. It can range from a relatively benign problem to aggressive growth that needs a form of chemotherapy.
The abundance of mast cells in such patients renders them particularly sensitive to allergen exposure. Thus, if one studies a population of adults who have anaphylaxis to stinging insect venom, one finds a significant percentage of patients who have mast cell disorders, so much so that screening is recommended. The first step is to have a tryptase blood level checked, which can typically be done at the allergist's office. Incidentally, anyone with stinging insect anaphylaxis should be treated with allergy shots against that venom to prevent another episode of anaphylaxis. In the meantime, an EpiPen or similar device should be carried.
Hope this helps.
Dr. VView Thread

Please be aware it depends on the allergy. If you are allergic to house dust mite, it is actually not a good idea to run a humidifier. Ambient humidity above 50% encourages the growth of dust mites, so in that situation running a humidifier may make the problem worse!
Your allergist should be able to advise you more specifically about this.
Good luck-
Dr. VView Thread


You are not allergic to trees -- only the pollen that the tree releases as part of its normal reproductive cycle. This typically happens in the springtime around April; depending on where you live, it could start as early as February as it does here in the South. There are plenty of pollen counts available online so that you can track what's going on in your area.
Regarding the apple problem, if a raw apple makes your mouth itch, then more than likely you are not allergic to apples themselves. Your body responds to birch pollen, and apples are among many fruits & vegetables that contain proteins that are highly similar in structure to birch. These are called Bet v 1 - related proteins (the major birch pollen allergen is called Bet v 1). Much is being learned about this phenomenon as researchers are working with sophisticated tools to try to uncover what makes a given protein allergenic.
In summary, this is not really an allergy to apples likely. It is a well-known form of cross-reactivity called Oral Allergy Syndrome, or Pollen-Food Allergy Syndrome (http://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergies-and-food-allergies-can-be-relate.aspx). The antibodies in your mouth and throat think that apple is a birch pollen! This could also happen with peaches, cherries, celery, carrot, and others. Importantly, if the fruit or veg is peeled or cooked, a reaction is much less likely since most of the proteins are in the skin and are susceptible to heating.
Hope this helps & good luck-
BrianView Thread

It takes more than a positive test result to diagnose someone with an allergy. Does your daughter have any symptoms if she eats something with milk or soy in it? Does she have a bad case of eczema or a more rare eosinophilic disorder in her intestine?
If she is a healthy girl who doesn't have immediate symptoms like hives, vomiting, or anaphylaxis with minutes after eating one of these foods, and she doesn't have eczema or other associated conditions, these tests might be meaningless; the important test is the "swallow" test -- what happens when she eats it? (We do these in the office when necessary, called an oral food challenge). Keep in mind about 50% of "normal" people will test positive to foods they tolerate, and there really is no difference between 3 and 4 . That's why it's really important to be careful about who gets tested and why. You might need a second opinion and/or a food challenge to safely determine whether your daughter truly is allergic and needs to continue avoiding these foods.
Hope this helps.
BrianView Thread

I am certainly aware that practitioners around the country are already offering this type of treatment to their patients. They are doing so against the advice of the research community, the FDA, and of the National Institute of Allergy and Infectious Disease at the NIH, all of whom have issued recommendations not to offer this to clinic patients yet. Keep in mind, the grand total of peanut-allergic patients worldwide in whom this therapy has been studied is somewhere around 100 - 200. Contrast that to a typical new drug study for another condition, say high blood pressure, in which tens of thousands of patients are often studied before a drug is released for clinical use. And then still in many cases we learn later that some of these drugs have safety problems not seen even when such a big sample is initially studied.
So the early studies have been promising, yes. And they will probably lead to a treatment. I can understand the rationale to go ahead and offer what is a desperately needed therapy. But more patients need studying and more scientific and regulatory issues need addressing, so that we can be sure that we have a safe and effective medicine. When that day comes, the FDA will license it for use and your insurance company will cover it. Stay tuned!
Good luck-
BrianView Thread

You raise some very important and still-unanswered questions about food immunotherapy. I appreciate your skepticism, as many people want to believe this is a cure, and it is not. We at Duke are among the centers around the country and world studying this approach. While we are excited about positive preliminary results, there is much left to learn, including but not limited to the questions you ask here. For these reasons, neither the FDA nor the professional allergy societies have approved this approach, and it should only be done on a research basis. It is not ready for clinical use yet.
Based on what has been shown to date, there appears to be a "desensitization" effect. This means that you must take a dose every day -- if you stop, the temporary effect of the desensitization will stop. It also means that a daily dose will likely protect you from a minor accidental exposure, but maybe not a major one. Your diet would remain otherwise free of peanuts -- this treatment does not allow you to eat whatever you want -- and you'd still need an autoinjector in case. Also, approximately 15-20% of folks that have tried this can't tolerate it due to allergic side effects, and have to stop taking it.
As you can see, this is not by any means a panacea but simply the first small step towards a treatment. It has been done only in very small numbers of highly selected patients, and at centers that have specific expertise in this area. It causes side effects, may not work for everyone, is not permanent, and should not be used as a treatment in the general community at this time.
Hope this helps-
BrianView Thread

Yours is a very common story, and what you have read is entirely correct. Most people who think they have penicillin allergy do not, especially if the original reaction occurred > 10 years ago.
That said, I completely agree with Amelia that the best way to evaluate this is to see an allergist. There are good tests now that can pretty clearly identify any possible risk to your taking penicillin or related drugs. And I do think it is worth having the evaluation because these antibiotics are very useful for typical kinds of infections like sinus, lung, skin, etc.
Good luck, and let us know what happens-
BrianView Thread

One possible consideration is hereditary angioedema (HAE). This is a disorder that produces relatively sudden attacks followed by a period of wellness and then another attack. This is relatively rare, and many ER docs don't know about it. Even some allergists may not have ever seen a case.
Typically, the attacks are characterized by pronounced swelling of the lips, tongue, or hands, and because of their rapid onset they may be mistaken for allergic reactions. One of the characteristic and distinguishing signs of HAE is quite severe abdominal pain during the attack, which is due to the same swelling problem occurring in the intestinal wall. This pain can be so intense that some HAE patients have been been taken straight to the operating room by a surgeon who is concerned about a severe problem when they examine the patient at the bedside. Your boyfriend's abdominal pain and difficulty breathing would concern me for HAE. Another consideration would be mastocytosis, which is another rare condition involving overgrowth of the mast cells that cause allergic reactions.
Hives are not typical of HAE attacks, so this may argue against this diagnosis. But it can usually be diagnosed by a relatively simple blood test, and the good news is that there are several new drugs which are highly effective for this condition. If you do a web search for the HAE advocacy organization, you can find more information about this condition to see if it's likely that your boyfriend has it; and you should be able to find a physician near you who has some expertise. When the HAE bloodwork is being sent, it may be a good idea to also check a tryptase level to rule out mastocytosis.
Hope this helps-
BrianView Thread

Let's clear a few things up. Allergies are due to a wayward response of the immune system. More specifically,
1. In contrast to the suggestion in the previous post, allergic reactions are in fact almost always due to an immune response to a protein. Sometimes those proteins have carbohydrates (sugars) attached to them, which may influence the reaction, but the immune response is primarily driven by the amino acid structure that forms the building blocks of protein. It is these relatively large structures that are "seen" by the T cells that initiate and sustain allergic immune responses.
So, for example, fish allergies are most commonly due to parvalbumin, a protein made by many whitefish. Iodine is a small molecule that is incapable by itself of generating an immune response, and it does not cause allergy.
2. The immune system excels at generating memory. So when you get infected with a bug you've already had, the body is prepared the second time around. Same is true for allergies. In general, if you are allergic, especially to a food, you react with each exposure, typically in similar ways -- this is due to memory. So if you regularly take whey protein (one of the three most common milk allergens) and don't have symptoms, you are not allergic to milk. Your memory cells would recognize it each time and give you trouble. While we're on the subject of milk, it is in fact the most common food allergy, affecting approximately 2.5% of U.S. children (or 1 in 40).
3. The relationship of food allergy to eczema is complicated. Foods can act as a trigger much like stress, bacteria, certain fabrics, etc. But eczema often has a mind of its own and affected patients have good days and bad days. It is common to associate exposures on bad days with flares but this can be tricky to sort out. If it's bothersome to you, your doc may need to help you with this.View Thread
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