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147 Egg allergy and adverse reactions to measles, mumps, rubella (MMR) vaccine
VOLUME NUMBER
145
MILE-INDUCED ASTHMAIN CHILDREN. Javesh Kanuua.M.D.,Edaar Yee.M.D , ami L. Bahna.N.D..Dr,P.H.Cleveland,bh~o. The role of food allergy in asthma is controversial and characteristics of such patients are unclear. We studied 32 children, 5 mo-11 yr (mean -34 mo., median 24 mo) with asthma (+/other atowic diseases). Milk allerov was supectkd in all by'history, ski&testing , or RAST to whole cow's milk, caseinj beta-lactoglobulin or alphalactalbumin. Supervisedoralchallenge with conventional cow's milk formula confirmedmilk-induced asthma [MIA) in lo/32 (31%), other atopic symptoms in 6/32 (19%), and negative or equivocal in 16/322(50%). -Age of onset of wheezing in the MIA group tended to be earlier than in the other patients (median 6.5 mo vs 9 mo). Total IaE elevation (>2SD) was mori frequent-in MIA; 00% vs 21% of the food challenae negative group. Positive or& challenge correlatedwithhistoryplus skin testing more than history plus BAST (80% vs 40%). Therefore, MIA is more likely to occur in children with total IgE and young age, elevated positive skin test to bovine milk proteins.
146 -AL
Abstracts
87 1. PART 2
FOODANTIGEN AVOIQ#KE DURING
Hattevia. M.D. Ph.D. FOUR Yvar . ele Sicurs. M.D. and Benat Klellmaa. D. , Dept Ped, SkCnrde and Boras, ..P. Sweden. 65 infants with family history of atopy and with mothers on a diet free from eggs, cow's milk and fish during the first 3 months of lactation (Dgroup) and 50 matched infants without maternal diet restrictions (ND-group) were followed prospectively 5 times during the first 18 months. The results have been published previously. At four years of age the children examined and skinwere interviewed, prick-tested (SPT) to 4 food- and 3 inhalant allergens. The cummulative and the current incidences of atopic dermatitis were significantly lower in the D-group (19 vs 28 and 6 vs 19, respecThe incidence of respiratory tively). symptoms was similar. The number of children with positive SPT was 7 D children and 11 ND children. We conclude that maternal diet restrictions during lactation seem to have long term effects on atopic dermatitis in children with heredity for atopic diseases. However, further studies are desirable and with larger and randomized groups and longer period of maternal diet.
147
Esfs~AND m,-
175
ADvmsERFAcrI~mMEAsLEs, Pm--
Wocd.WD).B?tPISanoson.Baltin?3re,Wary1and Inthisstudywe~toclarifysevwzl issues*~theuseof~vaccineinegg a&tm&crx3i3iw. we were &xa@ed to lb so ~nosystemicreactiorrj toFURineggallezgicchildrenMdidrxent1yevaluate2nmr-sgg allergicchildrentihad anaphy1acticreactix?sto!J9R.sixtyeggal1ergic&ildxenwereevaluatedastilastbe2 xn-eugallemicchildren.EcrsallercvwasconfirmZbyd&le-blind plaiied food c!hallerBPzaNIEIISAwasusedtodetectsenJmIgE and1gG-antib&iestot#4Randavalbsninzudtoovalbdninthe~.ofthe2~ allergicchildren, lhad a positive prick skin test (PST)to%?8x(full~ !dlnagativebypsTbutpositiveby lntradermal (ID) skin test (1:lOO). Of the egg allergic children, m to FX4R were positive in l/60 and ID were positive in 3/6 as well as in 2/6 non-allergic adultcontrols.Theonlyadversereacticnsto non-eggallergicchildren, mRoaYxredinthe2 boUiofvJhcmbadnoevidexeof IgEtoovalbmlin.FuLther,ibeanumt0fovalbumindetected i.ntMR (37 pghjection) wouldbs extrwely unlikelyto~allergicreadicns. Thi.sstudysuggeststhatfactorsotherthan egg sensitivity may be responsible for anaphylacticreacticnsto~ardraisesquestions abJlltthevallzofskinteststoF8lRinegg allergiccbildren.Usirgamfidence~s generatedforbirxxaialoutoaoe,thestudy provides 97%ccnfidencethatatleast 95%of egg alleryic&ildrenwilltoleraixtbeH4Rwithout difficulty.
148
A PROSPECIWE FOOD CHALLENGE STUDY OF 2 DIFFERENT TYPES OF SOY PROTEIN ISOLATES IN PATIENTS WITH POSSIBLE MILK OR SOY PROTEIN INTOI+ANCE. m
HB C&&e1 MD. SC Frm
I ,W
to the nowderedsov isolate challeneedone first but not thi secondchaijeugewith the l&id soy isolate. Four patients reactedto the liquid soyisolate challengefirst but not the secondchallengewith the powderedsoyisolate. In total, 9 patients reactedto the first soychallengeand not the second,regardless of which soyisolate was administeredfist. Theseresults indicate an order effect in the sov challengesbecauseof the tendencyto reaction O>I the first challengeregardlessofthe order of challenges.Possibleexplanationsfor this phenomenoninclude a transient tolerance and/or the depletion of gastrointestinalmediatorscausedby the first soychallenge,
145
MILE-INDUCED ASTHMAIN CHILDREN. Javesh Kanuua.M.D.,Edaar Yee.M.D , ami L. Bahna.N.D..Dr,P.H.Cleveland,bh~o. The role of food allergy in asthma is controversial and characteristics of such patients are unclear. We studied 32 children, 5 mo-11 yr (mean -34 mo., median 24 mo) with asthma (+/other atowic diseases). Milk allerov was supectkd in all by'history, ski&testing , or RAST to whole cow's milk, caseinj beta-lactoglobulin or alphalactalbumin. Supervisedoralchallenge with conventional cow's milk formula confirmedmilk-induced asthma [MIA) in lo/32 (31%), other atopic symptoms in 6/32 (19%), and negative or equivocal in 16/322(50%). -Age of onset of wheezing in the MIA group tended to be earlier than in the other patients (median 6.5 mo vs 9 mo). Total IaE elevation (>2SD) was mori frequent-in MIA; 00% vs 21% of the food challenae negative group. Positive or& challenge correlatedwithhistoryplus skin testing more than history plus BAST (80% vs 40%). Therefore, MIA is more likely to occur in children with total IgE and young age, elevated positive skin test to bovine milk proteins.
146 -AL
Abstracts
87 1. PART 2
FOODANTIGEN AVOIQ#KE DURING
Hattevia. M.D. Ph.D. FOUR Yvar . ele Sicurs. M.D. and Benat Klellmaa. D. , Dept Ped, SkCnrde and Boras, ..P. Sweden. 65 infants with family history of atopy and with mothers on a diet free from eggs, cow's milk and fish during the first 3 months of lactation (Dgroup) and 50 matched infants without maternal diet restrictions (ND-group) were followed prospectively 5 times during the first 18 months. The results have been published previously. At four years of age the children examined and skinwere interviewed, prick-tested (SPT) to 4 food- and 3 inhalant allergens. The cummulative and the current incidences of atopic dermatitis were significantly lower in the D-group (19 vs 28 and 6 vs 19, respecThe incidence of respiratory tively). symptoms was similar. The number of children with positive SPT was 7 D children and 11 ND children. We conclude that maternal diet restrictions during lactation seem to have long term effects on atopic dermatitis in children with heredity for atopic diseases. However, further studies are desirable and with larger and randomized groups and longer period of maternal diet.
147
Esfs~AND m,-
175
ADvmsERFAcrI~mMEAsLEs, Pm--
Wocd.WD).B?tPISanoson.Baltin?3re,Wary1and Inthisstudywe~toclarifysevwzl issues*~theuseof~vaccineinegg a&tm&crx3i3iw. we were &xa@ed to lb so ~nosystemicreactiorrj toFURineggallezgicchildrenMdidrxent1yevaluate2nmr-sgg allergicchildrentihad anaphy1acticreactix?sto!J9R.sixtyeggal1ergic&ildxenwereevaluatedastilastbe2 xn-eugallemicchildren.EcrsallercvwasconfirmZbyd&le-blind plaiied food c!hallerBPzaNIEIISAwasusedtodetectsenJmIgE and1gG-antib&iestot#4Randavalbsninzudtoovalbdninthe~.ofthe2~ allergicchildren, lhad a positive prick skin test (PST)to%?8x(full~ !dlnagativebypsTbutpositiveby lntradermal (ID) skin test (1:lOO). Of the egg allergic children, m to FX4R were positive in l/60 and ID were positive in 3/6 as well as in 2/6 non-allergic adultcontrols.Theonlyadversereacticnsto non-eggallergicchildren, mRoaYxredinthe2 boUiofvJhcmbadnoevidexeof IgEtoovalbmlin.FuLther,ibeanumt0fovalbumindetected i.ntMR (37 pghjection) wouldbs extrwely unlikelyto~allergicreadicns. Thi.sstudysuggeststhatfactorsotherthan egg sensitivity may be responsible for anaphylacticreacticnsto~ardraisesquestions abJlltthevallzofskinteststoF8lRinegg allergiccbildren.Usirgamfidence~s generatedforbirxxaialoutoaoe,thestudy provides 97%ccnfidencethatatleast 95%of egg alleryic&ildrenwilltoleraixtbeH4Rwithout difficulty.
148
A PROSPECIWE FOOD CHALLENGE STUDY OF 2 DIFFERENT TYPES OF SOY PROTEIN ISOLATES IN PATIENTS WITH POSSIBLE MILK OR SOY PROTEIN INTOI+ANCE. m
HB C&&e1 MD. SC Frm
I ,W
to the nowderedsov isolate challeneedone first but not thi secondchaijeugewith the l&id soy isolate. Four patients reactedto the liquid soyisolate challengefirst but not the secondchallengewith the powderedsoyisolate. In total, 9 patients reactedto the first soychallengeand not the second,regardless of which soyisolate was administeredfist. Theseresults indicate an order effect in the sov challengesbecauseof the tendencyto reaction O>I the first challengeregardlessofthe order of challenges.Possibleexplanationsfor this phenomenoninclude a transient tolerance and/or the depletion of gastrointestinalmediatorscausedby the first soychallenge,