White paper on peanut allergy: treatment pathway

ConclusionsAfter established diagnosis the standard of care is counseling to avoid peanut contact and prescription of emergency medications (oral antihistamines, oral steroids, inhaled β2-agonists, injectable intramuscular epinephrine) as needed. Instruction on the use of these emergency medications should be provided. A preparation for oral immunotherapy (OIT) for 4 to 17 years old peanut allergic children/ adolescents has been recently approved by the regulatory authorities. O IT for peanut allergy shows high efficacy and an acceptable safety profile, improves quality of life, and health economic aspects. Thus it offers a therapeutic option for peanut allergic children and adolescents.
Source: Allergo Journal International - Category: Allergy & Immunology Source Type: research

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Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
Peanut allergy is a common food allergy and the main cause of anaphylaxis among children. Peanut oral immunotherapy (pOIT) can lead to desensitization, and combined treatment with omalizumab may facilitate OIT initiation. Still, mechanisms of tolerance are not well understood. We therefore investigated transcriptional changes using RNA-seq profiles during omalizumab treatment and pOIT.Peanut-allergic adolescents (n=17, age 12-19 years) were included and treated with omalizumab for 8 weeks followed by a step-wise increase of daily peanut ingestion, and subsequent withdrawal of omalizumab. Finally, an open peanut challenge w...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric asthma and allergy Source Type: research
The key to managing anaphylaxis is early epinephrine administration. This can improve outcomes and prevent progression to severe and fatal anaphylaxis. Delayed or lack of administration of epinephrine is associated with fatal reactions. Positioning in a recumbent supine position, airway management, and intravenous fluids are essential in its management. Antihistamines and glucocorticosteroids should not be prescribed in place of epinephrine. β-adrenergic agonists by inhalation are indicated for bronchospasm associated with anaphylaxis despite optimal epinephrine treatment. Long-term management of anaphylaxis includes ...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Hymenoptera stinging insects are common culprits for allergic reactions. Anaphylaxis to insect stings can be life threatening and is associated with a significant risk of recurrence. Insect allergy requires referral to an allergist/immunologist for education and for diagnostic evaluation that will direct further management and treatment. Venom immunotherapy is safe and effective; it prevents sting anaphylaxis in up to 98% of patients. Potential risk factors for side effects during testing and treatment should be assessed for every patient to mitigate risk and to guide treatment recommendations and the duration of immunotherapy.
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
There are significant anaphylaxis data and knowledge gaps that result in suboptimal patient care and outcomes. To address these gaps there is need for collaborative, multidisciplinary research networks to strategically design practice changing research specific to the following anaphylaxis themes: Population Science, Basic and Translational Sciences, Acute Management, and Long-Term Management. Top priorities are to refine anaphylaxis diagnostic criteria, identify accurate diagnostic and predictive anaphylaxis biomarkers, standardize postanaphylaxis care (observation periods, hospitalization criteria), and determine immunot...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Subcutaneous allergen immunotherapy (SCIT) is a proven treatment of allergic rhinitis, asthma, atopic dermatitis, and prevention of Hymenoptera venom anaphylaxis. The known benefit of SCIT, however, must be considered in each patient relative to the potential risks of systemic allergic reactions (SRs). A mean of 1 SR per 1000 injection visits (0.1%) was estimated to occur between 2008 and 2018. Life-threatening anaphylactic events are estimated to occur in 1/160,000 injection visits. The factors that contribute to SRs and fatal reactions (FRs) are reviewed. Risk management strategies are proposed to prevent and decrease fu...
Source: Immunology and Allergy Clinics of North America - Category: Allergy & Immunology Authors: Source Type: research
Hymenoptera venom allergy may lead to severe allergic reactions to the point of life-threatening anaphylaxis. Between 0.3%-7.5% of adults [1] and 0.15-3.4% of children [2] develop systemic anaphylactic reactions, varying from mere cutaneous to severe organ symptoms [3]. The only causal therapy is Hymenoptera venom immunotherapy (IT) [4]. In affected patients, it is important to distinguish between honeybee and Vespula (yellow jacket) stings. This requires a detailed medical history that frequently requires photographic evidence.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Source Type: research
Hymenoptera venom allergy may lead to severe allergic reactions to the point of life-threatening anaphylaxis. Between 0.3% to 7.5% of adults1 and 0.15% to 3.4% of children2 develop systemic anaphylactic reactions, varying from mere cutaneous to severe organ symptoms.3 The only causal therapy is Hymenoptera venom immunotherapy (IT).4 In affected patients, it is important to distinguish between honeybee and Vespula (yellow jacket) stings. This requires a detailed medical history that frequently requires photographic evidence.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Letters Source Type: research
Emerg Med Clin North Am. 2022 Feb;40(1):33-37. doi: 10.1016/j.emc.2021.08.008. Epub 2021 Nov 2.ABSTRACTAfter treating the acute anaphylactic reaction, the clinician's next task is to prevent a recurrence. The patient should be observed in the ED. How long this observation period should last depends on their clinical course, risk factors, and social support. All patients should be discharged with a prescription for 2 epinephrine autoinjectors and counseled on appropriate use. The patient should also receive education on the signs and symptoms of anaphylaxis and avoiding triggers. The patient should follow-up with an allergy...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Source Type: research
Conclusion: To conclude, WOIT is an effective and safe modality of treatment if it is administered under strict supervision.Int Arch Allergy Immunol
Source: International Archives of Allergy and Immunology - Category: Allergy & Immunology Source Type: research
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