Food allergy in__ children.ppt

Common food allergies in different countries - USA: peanuts - Singapore: seafood - Sweden: fish - France: mustard - Israel: sesame * Food allergy in children Hugo Van Bever Department of Pediatrics National University Health System (NUHS) Singapore Shanghai, 7 – 8 May 2011 Food Allergy…Fact or Fiction? 1. Difficult problem group of diseases 2. Lot of non-scientific data … opinions… truths… tradition… stories. 3. Food other types of reaction (intolerance, intoxication, etc…) 4. Too many children are labeled as being “food-allergic” Adverse reactions to food Food intolerance (most common) Food allergy (hypersensitivity) Food aversion (phobia) FOOD INTOLERANCE - toxins - infections - pharmacological properties of food - host factors (lactase deficiency) Food allergy = an immunologically-mediated reaction against food 1. IgE-mediated Others… (less evidence) 2. Cell-mediated reactions (T lymphocytes - delayed onset) 3. Mixed types (atopic dermatitis) 4. Other mechanisms ( unknown - CIC – complement – etc…) Prevalence of food allergy 1. General population: 2 % 2. Young children ( 3 yrs): 8 % 3. Singapore children: 4 – 5 % SPECIFIC GROUPS 4. Young children with severe eczema: 90 % 5. Children with asthma: 10 % Manifestations of food allergy 1. SKIN: urticaria – angioedema eczema 2. RESPIRATORY: rhinitis – asthma 3. GI TRACT: diarrhea – vomiting – FTT - eosinophilic gastroenteritis - enterocolitis 4. GENERAL: anaphylactic shock 5. OTHER: migraine, hyperactivity, sleep disturbances etc… ? Foods triggering anaphylaxis in Singaporean children (1992 – 1996) 124 children with acute anaphylaxis at NUH mean age (yrs) 1. Egg and