73 Natural history of food hypersensitivity (FH) in children (PTS) with atopic dermatitis (AD)

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NATURAL HISTORY OF FOOD HYPERSENSITIVITY (PHI IN CHILDREN (PTS) WITH ATOPIC DERRATITIS (AD>. m SanDSOn RD and SR Scanlon RN Baltimore, RD. Patient6 with AD and FH adhering to an eliairination diet underwent repeat double-blind placebo-controlled oral food challengee annually for follow-up of FH. After 1 yr, 18171 pte lost all clinical FH (CFH); 14/46 pta to 1 food, Considering indiand 4121 to 2 foods. vidual foods. 31/100 no longer elicited eyaptonatic responeee. After 2 yr. 3135 pts lost FH and 5136 fooda elicited no response; after 3 yr no FH was lost in 16 patients teeted. Loss rata of FH varied between foodr; after 1 yr, there was 25% loam of CFH to 5 naJor allergen6
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REACTIONS TO FOODS IN ADULTS: AN OVERVIEW OF DIETARY CONSIDERATIONS. S,L. Parker, M,Sc.,G.L. Sussman, M.D,, S. Tarlo, M.D., A. Leznoff, M.D, and M. Krondl,Ph,D,, Toronto, Ontario In recent years there have been exponential increases in the frequency of perceived adverse reactions to foods. To characterize such people 45 adult allergy patients M:F of 1:5 underwent comprehensive clinical, psychological and dietary assessments. On the basis of the clinical skin prick testing and double blind history, food challenges patients were screened into 1 of 2 groups: 22 confirmed(c) 23 unconfirmed Cu)adverse reactions to foods. c patients reported fewer offending foods(mean 5)than did u patientscmean 26p 2 0.002). c patients were more likely to report conunon food allergens (crustaceans, legumes) while u rated dairy products and grains as most troublesome. c patients reported isolated episodes of classic allergic symptoms occurring within 2 hours of eating whereas u patients were more likely to report delayed onset(2-72 hours p< 0.001) atypical allergic symptoms(mood swGgs, confusion, fatigue). u patients exhibited some degree of psycholgic dysfunction. u patients consumed a less varied diet but were not nutritionally comprimised. We conclude: 1)confirmed adverse reaction to foods involved few foods, occur within minutes and resemble classic allergic reactions; 2)unconfinned reactions to foods involved multiple foods, usually occur after several hours and are often subjective in nature and 3)unconfirmed patients eat a non-conforming but nutritionally balanced diet and exhibit psychologic dysfunction. ADVERSE

-ROLE

OF THE ELIMINATION

L. Stocchi;

EA

0 Vassellatti; Aim of

false attribution of symptoms to allergy is a prevalent problem. Studies of the immunophysrolo ic correlates of cutaneous histamine reactive 4 y provided an informative appraisal of selected attributes of 40 predomoverweight subjects who inantly allergic attributed their frequent headaches to aspartame ingestion. A double blinded placebo-controlled cross-over challen e study with 30 I&"': 7 artame revealed t Ifiat the 3:X inciP headache after aspartame in these patients was not different from the 45% incidence of headache after lacebo (p=O.SO). Circulatin concentrations 0 f IgG IgA, IgM, c3 C4 and factor 'B glucose, I@, IgE, Slq histamine, ep&eph;ine and norepine{hrine,.and histamine induced.cutaneous flare responslveny;;m:nd sensi.tlvlty were normal. Low normal norepinephrine concentrations were fi etected patients who overweight (r&0.034) i:h increased followErthe onset of sjnn toms in subjects who devefiped headache (P&0002). Sensitivity to histamine induced cutaneous flare reactions was maximum in

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