TulsaAllergyNews

From Medscape Allergy & Immunology  by Marrecca Fiore

Introduction

Ever wonder what other allergists are reading?  After sorting through the long list of articles published on Medscape during the past year, it seems our member audience of allergists and clinical immunologists was most interested in:

• Food allergies
• Influenza
• Itching

The top 10 articles list is comprised of the most-read content of 2011. If you missed any of these articles, please take a look at them now.  Thanks Marrecca for your work on compiling the list. 

The List–I’ll comment when appropriate!

10. Office-Based Oral Food Challenge Safely Diagnoses Food Allergy
A letter published August 11th in the Journal of Allergy and Clinical Immunology said that food challenges can be safely done in a physician’s office as long as certain precautions are taken.

• Precautions include having resuscitative equipment in office during the challenge. 
• What foods do you challenge to?  I’d start out with egg, milk, wheat to name a few. 
• Some exciting potential for “desensitization” and oral tolerance as well.

9. Pathophysiology of Itch and New Treatments
As highlighted in this paper, the pathophysiology of itch is diverse and involves a complex network of cutaneous and neuronal cells. The article explains current treatments as well as experimental and promising therapies.

• Patients would rather have ANY symptom except itching. 
• Be careful!  Itching can be a result of correctable causes….like elevated bilirubin. Don’t miss this one.

8. What the New Food Allergy Guidelines Offer to Clinicians

Dr. Matthew Fenton from NIAID and Dr. Hugh Sampson, past president of AAAAI, review the food allergy guidelines and discuss how these principles should guide clinical practice.

• The most important guideline to follow–please avoid a food “panel” which misleads many patients to think they have a food allergy & you may just have an irrelevant positive test. 

7. The Itch That Rashes
A 2-year-old presents with a persistently itchy rash. What is the most appropriate management?

6. Common Variable Immunodeficiency at the End of a Prospering Decade: Towards Novel Gene Defects and Beyond
This review highlights the most important publications of the past year, with an emphasis on novel findings in genetics and the immunophenotype of CVID.

5. Molecular Diagnosis of Peanut and Legume Allergy
Peanut- and legume-induced allergic reactions can be fatal and can significantly impair the quality of life of patients and their families. This paper reviews and discusses recent studies on the molecular diagnosis of peanut and other legume allergy.

4. I’m Struggling to Live on $160,000 a Year: MD Lament
Most people who don’t have “MD” or “DO” after their name would assume that $160,000 is a good annual income. However, many physicians find it a challenge to live on that amount. Why can some manage easily while others are struggling to pay the bills?

3. Hymenoptera Venom Immunotherapy
Hymenoptera stings can induce allergic systemic and occasionally fatal reactions. What is the best treatment?

• Bee sting shots are >90% effective & I’ve learned much about allergy shots for pollens based on research for bee stings. 

2. Influenza Vaccine: Guidelines for Those With Egg Allergy
Vaccine expert Paul A. Offit, MD, explains the new influenza guidelines for individuals with egg allergy.

• The bottom line: Flu shot is probably safe even in patients with egg allergy.  This was taboo only 5 years ago….the more you know, the less you know!

1. New Test for Peanut Allergy a Step Forward
Measuring antibody levels of 2 peanut protein components in patients may be a better predictor of allergic reactions than current diagnostics.

Runners-Up

These articles did not make our Top 10, but they came close.

Can Inhaled Corticosteroids Prevent Asthma Exacerbations?
ICS therapy is the mainstay of asthma treatment, but can it also be used as a preventive measure?

Helping Families Manage Food Allergy in Schools
School can be a frightening place for food-allergic children and their parents. Are physicians providing the best information to help them?

Food-induced Anaphylaxis
Food allergy is an increasing problem in homes and schools. How do we determine who is at increased risk for anaphylaxis?

As always, if you have difficulty reading or obtaining any of these articles, let me know–I’ll be glad to help.