Hypersensitivity reactions to food

Prevalencija preosjetljivosti na hranu pokazuje pozitivan trend rasta; alergija na hranu pogađa gotovo 5% odraslih i 8% djece. Potencijalno ispravljivi čimbenici rizika uključuju nedostatak vitamina D, nezdravu masnoću u hrani, pretilost, povećanu higijenu i vrijeme izlaganja hrani, ali i genetika također igra važnu ulogu. Zanimljivi klinički uvidi u patogenezu uključuju otkrića vezana uz interakcije gena i okoliša i sve veće razumijevanje uloge ne-oralnog senzibilizirajućeg izlaganja koje uzrokuje alergiju na hranu. Dijagnoza alergije na hranu postavlja se na temelju anamneze, in vitro i in vivo testovima, eliminacijskom dijetom te oralnim provokacijskim testom. Sadašnje zbrinjavanje alergijskih reakcija uvelike se oslanja na isključivanje alergene hrane, što može dovesti do prehrambenih deficita i simptomatsku terapiju u hitnim slučajevima što uključuje pravovremenu primjenu autoinjektora adrenalina. Preporuke o prevenciji alergije na hranu i atopijskih bolesti putem dijetetskih mjera radikalno su se promijenile, uz ukidanje mnogih preporuka o opsežnom i dugotrajnom izbjegavanju alergena. Uključivanje jako zagrijanih (toplinski denaturiranih) oblika mlijeka i jaja u prehranu djece koja toleriraju ovu hranu umjesto strogog izbjegavanja predstavlja značajan pomak u kliničkom pristupu. Imunomodulacijska terapija je i dalje u fazi kliničkih ispitivanja ali se smatra da će imati značajnu ulogu u liječenju. Nadamo se da će trenutne i buduće kliničke studije razjasniti i pridonijeti boljoj i točnijoj dijagnozi te uspješnijem liječenju reakcija preosjetljivosti na hranu.Prevalence of food hypersensitivity shows a positive growth trend; food allergy affects nearly 5% of adults and 8% of children. Potentially correctable risk factors include vitamin D deficiency, unhealthy dietary fat, obesity, increased hygiene, and exposure time to food allergens, but genetics also play an important role. Interesting clinical insights into pathogenesis include discoveries related to gene and environmental interactions and an increasing understanding of the role of non-oral sensitizing exposure that causes food allergies. The food allergy diagnosis is based on clinical history, in vitro and in vivo tests, elimination diet and oral provocation test. Current allergic reaction management largely relies on the exclusion of food allergies, which can lead to nutritional deficits, and symptomatic emergency therapy, including application of adrenaline autoinjectors in time. Recommendations on the prevention of food allergy and atopic disease through dietary measures have radically changed, with the abolition of many recommendations on extensive and long-term avoidance of allergies. Significant shift in the clinical approach includes heavily heat (denatured) forms of milk and eggs in the diet of children tolerating this food instead of severe avoidance. Immunomodulation therapy has reached the level of clinical trials, showing promise to alter treatment. We hope that the current and future clinical studies will clarify and contribute to a better and more accurate diagnosis and to more successful treatment of the food hypersensitivity reactions

Hypersensitivity reactions to food

Prevalencija preosjetljivosti na hranu pokazuje pozitivan trend rasta; alergija na hranu pogađa gotovo 5% odraslih i 8% djece. Potencijalno ispravljivi čimbenici rizika uključuju nedostatak vitamina D, nezdravu masnoću u hrani, pretilost, povećanu higijenu i vrijeme izlaganja hrani, ali i genetika također igra važnu ulogu. Zanimljivi klinički uvidi u patogenezu uključuju otkrića vezana uz interakcije gena i okoliša i sve veće razumijevanje uloge ne-oralnog senzibilizirajućeg izlaganja koje uzrokuje alergiju na hranu. Dijagnoza alergije na hranu postavlja se na temelju anamneze, in vitro i in vivo testovima, eliminacijskom dijetom te oralnim provokacijskim testom. Sadašnje zbrinjavanje alergijskih reakcija uvelike se oslanja na isključivanje alergene hrane, što može dovesti do prehrambenih deficita i simptomatsku terapiju u hitnim slučajevima što uključuje pravovremenu primjenu autoinjektora adrenalina. Preporuke o prevenciji alergije na hranu i atopijskih bolesti putem dijetetskih mjera radikalno su se promijenile, uz ukidanje mnogih preporuka o opsežnom i dugotrajnom izbjegavanju alergena. Uključivanje jako zagrijanih (toplinski denaturiranih) oblika mlijeka i jaja u prehranu djece koja toleriraju ovu hranu umjesto strogog izbjegavanja predstavlja značajan pomak u kliničkom pristupu. Imunomodulacijska terapija je i dalje u fazi kliničkih ispitivanja ali se smatra da će imati značajnu ulogu u liječenju. Nadamo se da će trenutne i buduće kliničke studije razjasniti i pridonijeti boljoj i točnijoj dijagnozi te uspješnijem liječenju reakcija preosjetljivosti na hranu.Prevalence of food hypersensitivity shows a positive growth trend; food allergy affects nearly 5% of adults and 8% of children. Potentially correctable risk factors include vitamin D deficiency, unhealthy dietary fat, obesity, increased hygiene, and exposure time to food allergens, but genetics also play an important role. Interesting clinical insights into pathogenesis include discoveries related to gene and environmental interactions and an increasing understanding of the role of non-oral sensitizing exposure that causes food allergies. The food allergy diagnosis is based on clinical history, in vitro and in vivo tests, elimination diet and oral provocation test. Current allergic reaction management largely relies on the exclusion of food allergies, which can lead to nutritional deficits, and symptomatic emergency therapy, including application of adrenaline autoinjectors in time. Recommendations on the prevention of food allergy and atopic disease through dietary measures have radically changed, with the abolition of many recommendations on extensive and long-term avoidance of allergies. Significant shift in the clinical approach includes heavily heat (denatured) forms of milk and eggs in the diet of children tolerating this food instead of severe avoidance. Immunomodulation therapy has reached the level of clinical trials, showing promise to alter treatment. We hope that the current and future clinical studies will clarify and contribute to a better and more accurate diagnosis and to more successful treatment of the food hypersensitivity reactions

Hypersensitivity reactions to food

Prevalencija preosjetljivosti na hranu pokazuje pozitivan trend rasta; alergija na hranu pogađa gotovo 5% odraslih i 8% djece. Potencijalno ispravljivi čimbenici rizika uključuju nedostatak vitamina D, nezdravu masnoću u hrani, pretilost, povećanu higijenu i vrijeme izlaganja hrani, ali i genetika također igra važnu ulogu. Zanimljivi klinički uvidi u patogenezu uključuju otkrića vezana uz interakcije gena i okoliša i sve veće razumijevanje uloge ne-oralnog senzibilizirajućeg izlaganja koje uzrokuje alergiju na hranu. Dijagnoza alergije na hranu postavlja se na temelju anamneze, in vitro i in vivo testovima, eliminacijskom dijetom te oralnim provokacijskim testom. Sadašnje zbrinjavanje alergijskih reakcija uvelike se oslanja na isključivanje alergene hrane, što može dovesti do prehrambenih deficita i simptomatsku terapiju u hitnim slučajevima što uključuje pravovremenu primjenu autoinjektora adrenalina. Preporuke o prevenciji alergije na hranu i atopijskih bolesti putem dijetetskih mjera radikalno su se promijenile, uz ukidanje mnogih preporuka o opsežnom i dugotrajnom izbjegavanju alergena. Uključivanje jako zagrijanih (toplinski denaturiranih) oblika mlijeka i jaja u prehranu djece koja toleriraju ovu hranu umjesto strogog izbjegavanja predstavlja značajan pomak u kliničkom pristupu. Imunomodulacijska terapija je i dalje u fazi kliničkih ispitivanja ali se smatra da će imati značajnu ulogu u liječenju. Nadamo se da će trenutne i buduće kliničke studije razjasniti i pridonijeti boljoj i točnijoj dijagnozi te uspješnijem liječenju reakcija preosjetljivosti na hranu.Prevalence of food hypersensitivity shows a positive growth trend; food allergy affects nearly 5% of adults and 8% of children. Potentially correctable risk factors include vitamin D deficiency, unhealthy dietary fat, obesity, increased hygiene, and exposure time to food allergens, but genetics also play an important role. Interesting clinical insights into pathogenesis include discoveries related to gene and environmental interactions and an increasing understanding of the role of non-oral sensitizing exposure that causes food allergies. The food allergy diagnosis is based on clinical history, in vitro and in vivo tests, elimination diet and oral provocation test. Current allergic reaction management largely relies on the exclusion of food allergies, which can lead to nutritional deficits, and symptomatic emergency therapy, including application of adrenaline autoinjectors in time. Recommendations on the prevention of food allergy and atopic disease through dietary measures have radically changed, with the abolition of many recommendations on extensive and long-term avoidance of allergies. Significant shift in the clinical approach includes heavily heat (denatured) forms of milk and eggs in the diet of children tolerating this food instead of severe avoidance. Immunomodulation therapy has reached the level of clinical trials, showing promise to alter treatment. We hope that the current and future clinical studies will clarify and contribute to a better and more accurate diagnosis and to more successful treatment of the food hypersensitivity reactions

Rituximab, Intravitreal Bevacizumab and Laser Photocoagulation for Treatment of Macrophage Activation Syndrome and Retinal Vasculitis in Lupus: A Case Report

Systemic lupus erythematosus (SLE) most commonly manifests as mild to moderate disease with severe manifestations such as diffuse alveolar hemorrhage, central nervous system vasculitis, macrophage activation syndrome (MAS) or retinal vasculitis (RV) with visual disturbances occurring in a significantly smaller proportion of patients, most of whom have a poor outcome. Macrophage activation syndrome and RV are insufficiently early and rarely recognized presentations of lupus—consequently there are still no treatment recommendations. Here we present the course of diagnosis and treatment of a patient with an SLE flare that resulted in both life-threatening disease (MAS) and vision-threatening disease (RV). The patient was successfully treated with systemic immunosuppressives, a high dose of glucocorticoids and rituximab (RTX), in parallel with intraocular therapy, intravitreal bevacizumab (BEV) and laser photocoagulation