Prevalence of food allergy has been increasing over the last decades. It may appear as an immedia... more Prevalence of food allergy has been increasing over the last decades. It may appear as an immediate or a delayed reaction. The disease has a major impact on the quality of life of patients and their families, and it is associated to elevated costs. Primary care physicians are the first healthcare providers who assist children with food allergy, especially in mild to moderate forms. Through the present review, we examine the steps that should be followed in primary care to manage food allergy, and to promptly prescribe an elimination diet and an emergency kit in case of accidental exposure to the allergen. We also focus on the special management of IgE and non-IgE mediated cow's milk allergy, and on management and prevention of egg and peanuts allergy.
Allergy to glucocorticosteroids is a rare event, always surprising for anti-allergic drugs. The c... more Allergy to glucocorticosteroids is a rare event, always surprising for anti-allergic drugs. The clinical presentation is that of anaphylaxis. The drug allergy evaluation, comprising skin tests and possibly a provocation test, allows the demonstration of the role of the drug or one of its additives and to look for cross-reactivities and safe alternatives. This paper reviews the few case reports
International Archives of Allergy and Immunology, 2010
In patients sensitized to beta-lactams, a safe beta-lactam alternative is often needed. The objec... more In patients sensitized to beta-lactams, a safe beta-lactam alternative is often needed. The objective was to assess the safety of cefuroxime in patients with a proven beta-lactam allergy. Using the Drug Allergy and Hypersensitivity Database cohort, patients with a proven beta-lactam allergy and tested for cefuroxime between September 1996 and April 2007 were selected. The European Network of Drug Allergy recommendations were followed. Prevalence of sensitization to cefuroxime (as an alternative) was established in patients with a proven beta-lactam allergy. Amongst the 650 subjects tested, 143 (22.0%) presented at least one beta-lactam sensitization other than cefuroxime [39-27.3% male, median age at test 44.0 (32.0-56.0) years]. One hundred and eighteen (82.5%) were sensitized to penicillins, 8 (5.6%) to cephalosporins and 17 (11.9%) to both penicillins and cephalosporins. Nine (6.3%) patients were sensitized to cefuroxime (6 diagnosed by provocation test): 5 (55.6%) in the penicillin-only allergic group and 4 (44.4%) in the penicillin and cephalosporin allergic group. Prevalence of cefuroxime hypersensitivity reaction in patients sensitized to beta-lactams was 6.3% (95% CI 2.3-10.3%) and in those sensitized to penicillin 4.2% (95% CI 0.6-7.9). This rate decreased to 2.9% (95% CI 0-6.9) in patients with prior histories involving a penicillin only (without any history involving an unknown beta-lactam). Cefuroxime appeared to be a safe alternative in beta-lactam-allergic patients after testing. The risk of giving cefuroxime being not null, a thorough drug allergy work-up, including provocation test, is still needed.
Prevalence of food allergy has been increasing over the last decades. It may appear as an immedia... more Prevalence of food allergy has been increasing over the last decades. It may appear as an immediate or a delayed reaction. The disease has a major impact on the quality of life of patients and their families, and it is associated to elevated costs. Primary care physicians are the first healthcare providers who assist children with food allergy, especially in mild to moderate forms. Through the present review, we examine the steps that should be followed in primary care to manage food allergy, and to promptly prescribe an elimination diet and an emergency kit in case of accidental exposure to the allergen. We also focus on the special management of IgE and non-IgE mediated cow's milk allergy, and on management and prevention of egg and peanuts allergy.
Allergy to glucocorticosteroids is a rare event, always surprising for anti-allergic drugs. The c... more Allergy to glucocorticosteroids is a rare event, always surprising for anti-allergic drugs. The clinical presentation is that of anaphylaxis. The drug allergy evaluation, comprising skin tests and possibly a provocation test, allows the demonstration of the role of the drug or one of its additives and to look for cross-reactivities and safe alternatives. This paper reviews the few case reports
International Archives of Allergy and Immunology, 2010
In patients sensitized to beta-lactams, a safe beta-lactam alternative is often needed. The objec... more In patients sensitized to beta-lactams, a safe beta-lactam alternative is often needed. The objective was to assess the safety of cefuroxime in patients with a proven beta-lactam allergy. Using the Drug Allergy and Hypersensitivity Database cohort, patients with a proven beta-lactam allergy and tested for cefuroxime between September 1996 and April 2007 were selected. The European Network of Drug Allergy recommendations were followed. Prevalence of sensitization to cefuroxime (as an alternative) was established in patients with a proven beta-lactam allergy. Amongst the 650 subjects tested, 143 (22.0%) presented at least one beta-lactam sensitization other than cefuroxime [39-27.3% male, median age at test 44.0 (32.0-56.0) years]. One hundred and eighteen (82.5%) were sensitized to penicillins, 8 (5.6%) to cephalosporins and 17 (11.9%) to both penicillins and cephalosporins. Nine (6.3%) patients were sensitized to cefuroxime (6 diagnosed by provocation test): 5 (55.6%) in the penicillin-only allergic group and 4 (44.4%) in the penicillin and cephalosporin allergic group. Prevalence of cefuroxime hypersensitivity reaction in patients sensitized to beta-lactams was 6.3% (95% CI 2.3-10.3%) and in those sensitized to penicillin 4.2% (95% CI 0.6-7.9). This rate decreased to 2.9% (95% CI 0-6.9) in patients with prior histories involving a penicillin only (without any history involving an unknown beta-lactam). Cefuroxime appeared to be a safe alternative in beta-lactam-allergic patients after testing. The risk of giving cefuroxime being not null, a thorough drug allergy work-up, including provocation test, is still needed.
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Papers by Silvia Caimmi