46 results on '"Takanori Imai"'
Search Results
2. Japanese guidelines for food allergy 2020
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Motohiro Ebisawa, Komei Ito, Takao Fujisawa, Yukoh Aihara, Setsuko Ito, Takanori Imai, Yusei Ohshima, Yukihiro Ohya, Hideo Kaneko, Yasuto Kondo, Naoki Shimojo, Mizuho Nagao, Yasunori Ito, Yuzaburo Inoue, Ikuo Okafuji, Sakura Sato, Yoichi Nakajima, Hajime Nishimoto, Tatsuki Fukuie, Masaki Futamura, Tetsuharu Manabe, Noriyuki Yanagida, Yoshiyuki Yamada, and Atsuo Urisu
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lcsh:Immunologic diseases. Allergy ,0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Allergy ,Oral immunotherapy ,Guidelines ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Oral allergy syndrome ,Food allergy ,medicine ,Humans ,Immunology and Allergy ,Contraindication ,business.industry ,Oral food challenge ,Prevention ,digestive, oral, and skin physiology ,Disease Management ,General Medicine ,Guideline ,medicine.disease ,030104 developmental biology ,030228 respiratory system ,Disease Susceptibility ,lcsh:RC581-607 ,business ,Biomarkers ,Food Hypersensitivity ,Anaphylaxis - Abstract
Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients consume causative foods in any way and as early as possible.
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- 2020
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3. Low-dose l-isoproterenol versus salbutamol in hospitalized pediatric patients with severe acute exacerbation of asthma: A double-blind, randomized controlled trial
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Takanori Imai, Yasuo Ohashi, Mihoko Mizuno, Takao Fujisawa, Takanobu Maekawa, Koji Hashimoto, Yukihiro Ohya, Yuichi Adachi, Kenichi Akashi, Toshio Katsunuma, Mari S. Oba, Hidefumi Nakamura, and Mayumi Sako
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Male ,0301 basic medicine ,lcsh:Immunologic diseases. Allergy ,Exacerbation ,Drug Administration Schedule ,law.invention ,Double blind ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Administration, Inhalation ,medicine ,Humans ,Immunology and Allergy ,Albuterol ,Child ,Adverse effect ,Lung ,Asthma ,Inhalation ,business.industry ,Isoproterenol ,Infant ,General Medicine ,medicine.disease ,Bronchodilator Agents ,respiratory tract diseases ,Nebulizer ,Treatment Outcome ,030104 developmental biology ,030228 respiratory system ,Child, Preschool ,Anesthesia ,Salbutamol ,Female ,business ,lcsh:RC581-607 ,medicine.drug - Abstract
Background: Although the guidelines in most countries do not recommend continuous inhalation of l-isoproterenol to treat pediatric patients with acute severe exacerbation of asthma, lower dose of l-isoproterenol has been widely used in Japan. To determine whether the efficacy of low-dose l-isoproterenol was superior to that of salbutamol, we conducted a double-blind, randomized controlled trial. Methods: Hospitalized patients aged 1–17 years were eligible if they had severe asthma exacerbation defined by the modified pulmonary index score (MPIS). Patients were randomly assigned (1:1) to receive inhalation of l-isoproterenol (10 μg/kg/h) or salbutamol (500 μg/kg/h) for 12 hours via a large-volume nebulizer with oxygen. The primary outcome was the change in MPIS from baseline to 3 hours after starting inhalation. Trial registration number UMIN000001991. Results: From December 2009 to October 2013, 83 patients (42 in the l-isoproterenol group and 41 in the salbutamol group) were enrolled into the study. Of these, one patient in the l-isoproterenol group did not receive the study drug and was excluded from the analysis. Compared with salbutamol, l-isoproterenol reduced MPIS more rapidly. Mean (SD) changes in MPIS at 3 hours were −2.9 (2.5) in the l-isoproterenol group and −0.9 (2.3) in the salbutamol group (difference −2.0, 95% confidence interval −3.1 to −0.9; P
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- 2019
4. Evaluation of early skin or laryngeal reaction at oral food challenge
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Taro Kamiya, Yuki Okada, Takanori Imai, Mayu Maeda, and Toshinori Nakamura
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Allergy ,medicine.medical_specialty ,Multivariate analysis ,Oral food challenge ,business.industry ,Univariate ,Odds ratio ,Logistic regression ,medicine.disease ,Confidence interval ,Target dose ,Internal medicine ,Medicine ,business - Abstract
Background: An oral food challenge (OFC) is required for diagnosing food allergies; however, uncertain reactions can impair the determination of when to stop the test. We aimed to determine the associations between immediately occurring mild allergic skin signs/laryngeal symptoms and positive OFC results. Methods: We retrospectively included children (aged 6 months to 15 years) who underwent open OFC for hen’s egg (HE), cow’s milk (CM), or wheat at a single centre between May 2012 and March 2020. Participants with mild skin signs or laryngeal symptoms at OFC initiation were classified as “skin” or “laryngeal” cases, respectively. Using logistic regression, the risk of positive OFC results, in a skin or laryngeal case, was assessed using univariate and multivariate analyses. Age, sex, total target dose, and serum levels of total and food-specific immunoglobulin E were used as covariates in prediction models. Results: In total, 2954, 1126, and 850 tests for HE, CM, and wheat, respectively, were included and comprised 115 (4%) and 25 (0.9%), 92 (9%) and 24 (2%), and 7 (1.3%) and 0 (0%) skin and laryngeal cases, respectively. Children with reactions to both HE and CM had a higher risk of a positive OFC than controls (odds ratio [95% confidence interval]: 4.6 [3.3–6.4], 2.9 [2.0–4.1] and 6.5 [3.0–10.9], 4.9 [2.2–10.9], respectively). Areas under the curves of prediction models ranged from 0.61 to 0.71. Conclusions: Uncertain reactions immediately after test initiation could not robustly predict OFC results, indicating the OFC could be continued under careful observation.
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- 2021
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5. Effect of oral immunotherapy in children with milk allergy: The ORIMA study
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Satoshi Fujita, Ayako Kimura, Hitomi Tada, Ryoko Ishikawa, Kenji Matsumoto, Taro Kamiya, Toshinori Nakamura, Mayu Maeda, Toshio Katsunuma, Kenichi Akashi, Hideaki Morita, and Takanori Imai
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lcsh:Immunologic diseases. Allergy ,Male ,medicine.medical_specialty ,Oral immunotherapy ,Efficacy ,Administration, Oral ,Milk allergy ,Cow's milk allergy ,Double-Blind Method ,Japan ,Allergic symptoms ,Internal medicine ,medicine ,Immunology and Allergy ,Animals ,Humans ,Adverse effect ,Child ,Pediatric ,Oral food challenge ,business.industry ,Incidence (epidemiology) ,Gene Expression Profiling ,food and beverages ,General Medicine ,Allergens ,Immunoglobulin E ,medicine.disease ,Milk ,Desensitization, Immunologic ,Child, Preschool ,Leukocytes, Mononuclear ,Female ,Immunotherapy ,Gradual increase ,Safety ,Milk Hypersensitivity ,business ,lcsh:RC581-607 - Abstract
Background: This study was aimed at evaluating the efficacy and safety of oral immunotherapy (OIT) in children with severe cow's milk allergy. Methods: The subjects comprised 28 children (aged 3–12 years) with allergic symptoms that were induced by ≤ 10 mL of cow's milk in an oral food challenge test (OFC). The subjects were randomly allocated to the treatment group (n = 14) and control group (n = 14); the former received rush immunotherapy for 2 weeks, followed by a gradual increase of cow's milk volume to 100 mL for 1 year, and the latter completely eliminated cow's milk for 1 year. Both groups underwent an OFC with 100 mL of cow's milk after 1 year. Results: The treatment group had significantly higher rates of a negative OFC [7/14 (50%) vs. 0/14 (0%), p 100 mL). Conclusions: The effect of immunotherapy was 50%, but the incidence of adverse events was not low. Further studies focusing on safety is necessary to standardize OIT for cow's milk allergy.
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- 2020
6. Predictors of Persistent Wheat Allergy in Children: A Retrospective Cohort Study
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Tomoyuki Asaumi, Kiyotaka Ohtani, Sakura Sato, Noriyuki Yanagida, Kiyotake Ogura, Takanori Imai, Motohiro Ebisawa, and Yumi Koike
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Male ,medicine.medical_specialty ,Immunology ,Wheat Hypersensitivity ,Immunoglobulin E ,03 medical and health sciences ,0302 clinical medicine ,Food allergy ,Internal medicine ,Immune Tolerance ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Triticum ,Retrospective Studies ,chemistry.chemical_classification ,biology ,Oral food challenge ,business.industry ,Infant ,food and beverages ,Anaphylactic reactions ,Retrospective cohort study ,General Medicine ,medicine.disease ,Gluten ,030228 respiratory system ,chemistry ,Child, Preschool ,biology.protein ,Female ,business ,Wheat allergy ,Anaphylaxis - Abstract
Background: Wheat allergy is the third most common food allergy that develops during infancy in Japan. To identify factors associated with persistent wheat allergy, we assessed the rate of tolerance acquisition among Japanese children aged less than 6 years with an immediate-type wheat allergy using the oral food challenge (OFC) method. Methods: This retrospective cohort study included 83 children (born in 2005–2006) who had a history of immediate-type allergic reaction to wheat and were followed until 6 years of age. The subjects were divided to form “tolerant” (n = 55; tolerance acquired by 6 years of age) and “allergic” (n = 28; tolerance not acquired by 6 years of age) groups based on their OFC results. Results: The rates of tolerance acquisition to 200 g of udon noodles at 3, 5, and 6 years of age were 20.5% (17/83), 54.2% (45/83), and 66.3% (55/83), respectively. The total number of anaphylactic reactions experienced prior to 3 years of age in response to all foods (p < 0.01) and to wheat (p = 0.043) was significantly higher in the allergic than in the tolerant group. Wheat- and ω-5 gliadin-specific immunoglobulin E (IgE) levels were significantly higher in the allergic group than in the tolerant group (p < 0.01), and wheat-specific IgE levels were more likely to increase after infancy in the allergic group. Conclusions: A history of anaphylaxis to all foods including wheat and/or a high level of wheat- or ω-5 gliadin-specific IgE antibodies were identified as risk factors for persistent wheat allergy.
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- 2018
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7. Commentary on Japanese Pediatric Guideline for Food Allergy 2016 Chapter 12 Gastrointestinal food allergies and the related diseases
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Takanori Imai, Yusei Ohshima, and Yoshiyuki Yamada
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030201 allergy ,03 medical and health sciences ,medicine.medical_specialty ,Allergy ,0302 clinical medicine ,Food allergy ,business.industry ,Family medicine ,medicine ,Guideline ,medicine.disease ,business - Published
- 2018
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8. The prevalence and management of allergic diseases among kindergartens and nurseries in Tokyo
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Yoko Nadaoka, Kazue Ezawa, Takanori Imai, Tsutomu Iwata, Kaoru Suzuki, and Akira Akasawa
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medicine.medical_specialty ,Pediatrics ,Food allergy ,business.industry ,Family medicine ,medicine ,medicine.disease ,business - Published
- 2017
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9. Natural history of immediate-type hen's egg allergy in Japanese children
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Akinori Syukuya, Noriyuki Yanagida, Yumi Koike, Kiyotake Ogura, Kiyotaka Ohtani, Motohiro Ebisawa, Takanori Imai, Katsuhito Iikura, Sakura Sato, and Tomoyuki Asaumi
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Male ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Allergy ,Eggs ,Immunoglobulin E ,03 medical and health sciences ,0302 clinical medicine ,Egg White ,Japan ,Ovomucoid-specific IgE ,Risk Factors ,Tolerance acquisition ,Internal medicine ,Immune Tolerance ,medicine ,Animals ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Egg Hypersensitivity ,Retrospective Studies ,Asthma ,biology ,Oral food challenge ,business.industry ,Incidence ,Infant, Newborn ,Infant ,General Medicine ,Atopic dermatitis ,Allergens ,medicine.disease ,Hen's egg ,030228 respiratory system ,Child, Preschool ,Egg allergy ,Immunology ,biology.protein ,Egg white-specific immunoglobulin E (IgE) antibodies ,Female ,lcsh:RC581-607 ,business ,Chickens ,Anaphylaxis ,Egg white - Abstract
Background Hen's egg (HE) allergy develops during infancy. We investigated tolerance acquisition in Japanese children allergic to HE aging Methods In this retrospective study, 226 children born in 2005 with a history of immediate-type HE allergy underwent an oral food challenge (OFC). Tolerance was defined as no reaction to an OFC with half of whole heated HE or accidental HE consumption at home. Participants were divided into three groups based on age at tolerance acquisition: group I ( n = 66), group II (3–6 years) ( n = 98), and group III (prolonged allergic groups) ( n = 62). Results Tolerance acquisition occurred in 30% (66/226) by 3 years of age, 59% (133/226) by 5 years of age, and 73% (164/226) at 6 years of age. At 3 years, incidences of allergy-related complications (bronchial asthma, p = 0.02; atopic dermatitis, p = 0.04) were higher in the group III than in the group I. Anaphylaxis to any food occurred more frequently in the group III than in the group I ( p = 0.03); anaphylaxis to HE was more common in the group III ( p = 0.04). Egg white (EW)- and ovomucoid (OM)-specific immunoglobulin E (IgE) levels were higher in the group III than in the group I ( p Conclusions The group III experienced HE-related anaphylaxis and complications more frequently and exhibited sustained, high EW- and OM-specific IgE levels.
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- 2016
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10. Evaluation of oral immunotherapy efficacy and safety by maintenance dose dependency: A multicenter randomized study
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Norio Kawamoto, Naoyuki Kando, Kazuko Sugai, Masami Taniguchi, Komei Ito, Rumiko Shibata, Yoko Murakami, Masanori Ikeda, Osamu Uchida, Yasuto Kondo, Mitsuyoshi Urashima, Takanori Imai, Sakura Sato, Ikuya Tsuge, Kiyotake Ogura, Noriyuki Yanagida, Naomi Kondo, Takao Fujisawa, Atsuo Urisu, Motohiro Ebisawa, and Mizuho Nagao
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lcsh:Immunologic diseases. Allergy ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Food hypersensitivity ,Dose-response relationship ,medicine.medical_treatment ,CM, cow’s milk ,Immunology ,sIgE, specific immunoglobulin E ,Desensitization ,Immunoglobulin E ,Gastroenterology ,Article ,SU, sustained unresponsiveness ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Food allergy ,law ,Internal medicine ,medicine ,Immunology and Allergy ,Ingestion ,030223 otorhinolaryngology ,StU, short-term unresponsiveness ,Desensitization (medicine) ,biology ,Oral food challenge ,business.industry ,Maintenance dose ,HE, hens’ egg ,food and beverages ,OIT, oral immunotherapy ,SLIT, sublingual immunotherapy ,medicine.disease ,OFC, oral food challenge ,sIgG4, specific immunoglobulin G4 ,sIgG, specific immunoglobulin G ,Dose–response relationship ,EPIT, epicutaneous immunotherapy ,030228 respiratory system ,FA, food allergy ,biology.protein ,Immunotherapy ,lcsh:RC581-607 ,business - Abstract
Background: Generally, oral immunotherapy (OIT) aims for daily administration. Recently, the efficacy of treatment with OIT at a low dose has been reported. However, the optimal dose and the evaluation of dose-dependent OIT outcome have not been described. Methods: A multicenter, parallel, open-labeled, prospective, non-placebo controlled, randomized study enrolled 101 Japanese patients for treatment with OIT. We hypothesized that target dose OIT would induce short-term unresponsiveness (StU) earlier than reduced dose OIT. StU was defined as no response to 6200 mg whole egg, 3400 mg milk, and 2600 mg wheat protein, as evaluated by oral food challenge after 2-week ingestion cessation. To compare the two doses of OIT efficacy, the maximum ingestion doses during the maintenance phase of OIT were divided into 100%-dose or 25%-dose groups against their target StU dose, respectively. A total of 51 patients were assigned to the 100%-dose group [hen's egg (HE) = 26, cow's milk (CM) = 13, wheat = 12] and 50 to the 25%-dose group (HE = 25, CM = 13, wheat = 12). Primary outcome was established by comparing StU at 1 year. Secondary outcome was StU at 2 years and established by comparing allergic symptoms and immunological changes. Results: The year 1 StU rates (%) for the 100%- and 25%-dose groups were 26.9 vs. 20.0 (HE), 7.7 vs. 15.4 (CM), and 50.0 vs. 16.7 (wheat), respectively. The year 2 StU rates were 30.8 vs. 36.0 (HE), 7.7 vs. 23.1 (CM), and 58.3 vs. 58.3 (wheat), respectively. There were no statistically significant differences in StU between years 1 and 2. The total allergic symptom rate in the 25%-dose group was lower than that in the 100%-dose group for egg, milk, and wheat. Antigen-specific IgE levels for egg-white, milk, and wheat decreased at 12 months. Conclusions: Reduced maintenance dose of egg OIT showed similar therapeutic efficacy to the target dose. However, we were not able to clearly demonstrate the efficacy, particularly for milk and wheat. Reducing the maintenance dose for eggs, milk, and wheat may effectively lower the symptoms associated with their consumption compared to the target OIT dose. Furthermore, aggressive reduction of the maintenance dose might be important for milk and wheat, compared to the 25%-dose OIT. Trial registration: UMIN000009373, Multicenter Oral Immunotherapy for Hen's Egg, Cow's Milk, and Wheat-Allergic Children at Outpatient Clinic.
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- 2020
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11. Oral challenge tests for soybean allergies in Japan: A summary of 142 cases
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Motohiro Ebisawa, Akinori Shukuya, Tomohiro Utsunomiya, Takatsugu Komata, Sakura Sato, Miki Sato, Morimitsu Tomikawa, and Takanori Imai
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Male ,0301 basic medicine ,lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Allergy ,Administration, Oral ,Immunoglobulin E ,Sensitization ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Respiratory system ,Child ,Retrospective Studies ,Skin Tests ,biology ,business.industry ,Allergic reaction ,Infant ,food and beverages ,General Medicine ,Food challenge test ,Allergens ,medicine.disease ,Titer ,030104 developmental biology ,medicine.anatomical_structure ,Epinephrine ,030228 respiratory system ,Child, Preschool ,Immunology ,biology.protein ,Female ,Immunization ,IgE ,Soybeans ,business ,Challenge tests ,lcsh:RC581-607 ,Food Hypersensitivity ,Anaphylaxis ,medicine.drug - Abstract
Background Soybeans are one of causative foods for infantile onset allergies in Japan. This study aimed to analyze the results of soybean challenge tests that were conducted over approximately 7 years at our institution. Using the test data, we sought to identify the responses and clinical profiles of patients with soybean allergies, and to investigate the relationship between the responses and soybean sensitization status. Methods Between July 2004 and May 2010, 142 cases (125 patients) underwent food challenge tests (100 g of silken tofu) for the diagnosis of soybean allergy or confirmation of their tolerance. The patients' characteristics, soybean sensitization status, and responses to the challenge tests were retrospectively evaluated. Results Among the subjects who underwent the soybean challenge test, the male/female ratio was 1.6 (87/55), and the mean age at the test was 2.8 ± 1.7 years. The positive rate for the challenge test was 38.7%. Induced symptoms were observed in the skin (81.8%), respiratory system (50.9%), and gastrointestinal system/mucosal membrane/anaphylaxis (12.7%). Intramuscular epinephrine was administered to all 7 patients who experienced an anaphylactic reaction. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic efficiency of soybean-specific IgE titers were low for predicting the responses to the challenge test. Conclusions Soybean allergies were diagnosed in only 18% of the subjects with positive sensitization to soybeans. Therefore, soybean-specific IgE titers are not an effective predictor of a positive response to the challenge test.
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- 2016
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12. Three-year-old boy with acute pancreatitis associated with peanut allergy
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Yoshifusa Abe, Toshinori Nakamura, Mayu Shimizu, Yoshitaka Watanabe, Kazuo Itahashi, Takanori Imai, and Koji Morita
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medicine.medical_specialty ,business.industry ,Peanut allergy ,medicine ,Acute pancreatitis ,General Medicine ,medicine.disease ,business ,Dermatology - Published
- 2015
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13. The Skin Prick Test is Not Useful in the Diagnosis of the Immediate Type Food Allergy Tolerance Acquisition
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Takatsugu Komata, Takanori Imai, Motohiro Ebisawa, Mika Ogata, Noriyuki Yanagida, and Morimitsu Tomikawa
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lcsh:Immunologic diseases. Allergy ,Male ,food hypersensitivity ,Allergy ,medicine.medical_specialty ,Eggs ,Wheat Hypersensitivity ,Immunoglobulin E ,medicine.disease_cause ,Immune tolerance ,tolerance acquisition ,Allergen ,Antibody Specificity ,oral food challenge ,Food allergy ,Immune Tolerance ,medicine ,Animals ,Humans ,Immunology and Allergy ,Child ,Retrospective Studies ,Skin Tests ,food allergy ,biology ,business.industry ,Oral food challenge ,Infant ,Wheal Size ,General Medicine ,Allergens ,medicine.disease ,Dermatology ,skin prick test ,Milk ,ROC Curve ,Child, Preschool ,Immunology ,biology.protein ,Cattle ,Female ,lcsh:RC581-607 ,business ,Egg white - Abstract
Background : Some studies have been reported about positioning of SPT in the diagnosis of food allergy. On the other hand, it is not yet clear about the positioning of SPT in the diagnosis of tolerance acquisition of the immediate type food allergy. Methods The retrospective study had been conducted for 236 egg allergic children (51.3 months in mean), 127 milk allergic children (53.4 months), and 96 wheat allergic children (42.6 months). The retrospective analysis of serum nonspecific and antigen-specific IgE levels, SPT, and OFC had been conducted for each allergic patient. All OFC had been conducted to verify the acquisition of tolerance against eliminated food. Results: The OFC was positive in 61 (25.8%) hen's egg allergies, 34 (26.8%) milk allergies and 33 (34.4%) wheat allergies. The greatest AUC for each allergen is as following; hen's egg for egg white specific IgE at 0.745, milk/histamine (wheal) index at 0.718, and wheat for wheal size at 0.597. For the predictive decision points, the highest accuracy rate was at 25.8% for an egg white wheal of 9.5 mm, at 26.8% for a milk wheal of 9.5 mm, and at 34.4% for a wheal of 6.5 mm. Conclusions As a result of this analysis, the diagnostic accuracy of SPT had not been satisfactory to judge the acquisition of tolerance in allergic children for eggs, milk and wheat. Therefore, this is not a strong evidence to testify the tolerance of the immediate type food allergy.
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- 2014
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14. Inappropriate food elimination affects quality of life of food allergy patients and guardians
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Sakura Sato, Takanori Imai, Miho Hasegawa, Takatsugu Komata, Noriyuki Yanagida, Noriko Hayashi, Motohiro Ebisawa, Akinori Shukuya, and Morimitsu Tomikawa
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medicine.medical_specialty ,Quality of life (healthcare) ,Food allergy ,business.industry ,medicine ,medicine.disease ,business ,Intensive care medicine - Abstract
目的 食物アレルギーの診療は手引きやガイドラインにより標準化されつつあるが,未だ不適切な除去による制限が患者及び保護者の生活の質(QOL)を低下させている例も少なくない.そこで多品目に及ぶ不適切な除去の指示が患者と保護者に与える影響を検証した. 方法 当科受診前に鶏卵,牛乳,小麦,米,大豆,肉,魚など主要食物5品目以上を含む多品目の除去を指示され,受診後それが大幅に是正された30名を対象に調査した. 結果 受診前後で患者の除去食物数は,12.0±2.8品から5.0±2.3品と大幅に減少し,除去解除率は,米,牛肉100%,鶏肉,豚肉80%以上,大豆,魚が50%以上だった.アンケート調査から,いずれも受診後に生活の物理的,精神的負担が有意に軽減され,除去食物数だけでなく,授乳中の母の厳しい食物除去や,厳格な回転食などが保護者の負担を増大させる要因となっていた. 考察 適切な診断に基づく食物除去によって,患者の様々な負担は大幅に軽減した.今後,食物アレルギー患者が標準的な診断を受け,最小限の食物除去に基づいた栄養指導で治療中もQOLが維持されることが望まれる.
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- 2011
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15. Utility of the Peripheral Blood Basophil Histamine Release Test in the Diagnosis of Hen’s Egg, Cow’s Milk, and Wheat Allergy in Children
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Takatsugu Komata, Akinori Shukuya, Morimitsu Tomikawa, Takanori Imai, Sakura Sato, Mika Ogata, Hiroshi Tachimoto, and Motohiro Ebisawa
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Male ,Immunology ,Basophil degranulation test ,Administration, Oral ,Basophil Degranulation Test ,Wheat Hypersensitivity ,Immunologic Tests ,Biology ,Basophil ,Histamine Release ,Sensitivity and Specificity ,behavioral disciplines and activities ,Dermatitis, Atopic ,chemistry.chemical_compound ,Food allergy ,Prohibitins ,mental disorders ,medicine ,Humans ,Immunology and Allergy ,In patient ,Child ,Egg Hypersensitivity ,Oral food challenge ,digestive, oral, and skin physiology ,General Medicine ,Allergens ,Immunoglobulin E ,medicine.disease ,Asthma ,Peripheral blood ,Antibodies, Anti-Idiotypic ,medicine.anatomical_structure ,ROC Curve ,nervous system ,chemistry ,Child, Preschool ,Female ,Milk Hypersensitivity ,psychological phenomena and processes ,Histamine ,Wheat allergy - Abstract
Background: The diagnosis of food allergy (FA) is made by oral food challenge tests (OFCs) that occasionally produce serious symptoms in patients; therefore, whether to perform OFCs should be carefully considered. The utility of the histamine release test (HRT) in the diagnosis of childhood FA has not been fully examined. Methods: Sixty-four subjects with suspected hen’s egg allergy, cow’s milk allergy (CMA), and wheat allergy (WA) were enrolled. The diagnosis of FA was made based on the outcomes of OFCs or a convincing history of symptoms after food ingestion within 6 months before or after sample collection. HRT was performed using an HRT Shionogi kit. The threshold of histamine release (HRT threshold), which was defined as the minimum concentration of food antigen to induce a 10% net histamine release, was analyzed in association with FA diagnosis. Results: Receiver operating characteristic analysis showed that the HRT threshold was useful in the diagnosis of heated egg allergy (HEA), raw egg allergy (REA), CMA, and WA. We were able to determine the cutoff value for the HRT threshold in relation to outcomes of OFCs. The cutoff value was 6 ng/ml of egg white antigen in HEA and REA (p < 0.01), 40 ng/ml of milk antigen in CMA (p < 0.01), and 500 ng/ml of wheat antigen in WA (p < 0.05). The efficiency was 70.3% for HEA, 78.0% for REA, 77.6% for CMA, and 70.7% for WA. Conclusions: We conclude that the HRT threshold measurement for egg white, milk, and wheat antigen is related to outcomes of OFCs and is useful in determining when OFCs should be performed.
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- 2011
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16. Development of Adherence Questionnaire for Children and Adolescents with Asthma
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Mizuho Nagao, Takanori Imai, Takao Fujisawa, Hiroshi Odajima, Chizu Habukawa, Yasunori Sato, Naoki Shimojo, Motohiro Ebisawa, Natoka Itoh-Nagato, Yumi Mizuno, and Yukihiro Ohya
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medicine.medical_specialty ,business.industry ,Family medicine ,Immunology ,medicine ,Immunology and Allergy ,medicine.disease ,business ,Asthma - Published
- 2018
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17. Food Allergy and Nutritional Care
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Chizuko Sugizaki, Miho Hasegawa, Motohiro Ebisawa, Noriko Hayashi, and Takanori Imai
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Diet counseling ,medicine.medical_specialty ,business.industry ,Food allergy ,Family medicine ,medicine ,Nutritional care ,business ,medicine.disease ,Biotechnology - Abstract
食物アレルギーが先進国を中心に増加している。現在わが国では乳幼児では約5-10%,学童で約2%が何らかの食物に対してアレルギーを起こすと推定されている1)。保育園,幼稚園,学校での給食などにも影響することなので,食物アレルギーを持つ患者への社会的な対応が求められる。食物アレルギー患者に対しては管理栄養士も食物アレルギーに関して最新の知識や情報を得て,栄養指導に臨む必要がある。食物アレルギー患者に関わる管理栄養士にこの「食物アレルギーと栄養指導」をご一読いただき,食物アレルギー患者とそのご家族のQOL(Quality of Life)の向上に貢献していただけることを期待している。(オンラインのみ掲載)
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- 2010
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18. [Untitled]
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Takanori Imai and Yasuhei Odajima
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business.industry ,Food allergy ,Environmental health ,Medicine ,Food science ,business ,medicine.disease - Abstract
背景: 食物アレルギーは除去食療法がいまだ治療の主体であり, 食物アレルギーが耐性化しない学童は, 学校給食においても同治療が必要となる.目的: 我が国の学校給食における食物アレルギー対策の現状と問題点を把握し, 今後の指針とする.方法: (社) 全国学校栄養士協議会の研修会に2003年1~3月に参加した学校栄養士555名を対象にアンケートを配布回収した.結果: 食物アレルギー児を抱えている栄養士は76.0% (422/555) であり, このうち食物アレルギー食の提供を行っている施設は68.7% (290/422) に過ぎなかった. 除去が必要な抗原は乳製品, 鶏卵, 甲殻・貝類, 魚類, ピーナツの順で多かった. 学校給食で食物アレルギー症状を経験したものは27.2% (151/555) であり, このうち医療機関の受診を要したものは46.4% (70/151) であった.結論: 学校給食における食物アレルギー児への対策は現状で満足できるものではない. 全ての食物アレルギー児に対して個別に対応し, 食物アレルギー食を提供できる理想的な環境を整える努力を始める必要がある.
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- 2004
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19. Food Allergy in Japan
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Hiroshi Tachimoto, Takanori Imai, Motohiro Ebisawa, and Kaori Ikematsu
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Food allergy ,business.industry ,Environmental health ,medicine ,Immunology and Allergy ,medicine.disease ,business - Published
- 2003
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20. Wheat oral immunotherapy for wheat-induced anaphylaxis
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Kiyotake Ogura, Motohiro Ebisawa, Takanori Imai, Tomohiro Utsunomiya, Noriyuki Yanagida, Yumi Koike, Noriko Hayashi, Akinori Shukuya, Yu Okada, Tomoyuki Asaumi, and Sakura Sato
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Male ,Oral immunotherapy ,Adolescent ,business.industry ,medicine.medical_treatment ,Immunology ,Administration, Oral ,Wheat Hypersensitivity ,Wheat hypersensitivity ,medicine.disease ,law.invention ,Randomized controlled trial ,Double-Blind Method ,law ,Desensitization, Immunologic ,Anesthesia ,medicine ,Immunology and Allergy ,Humans ,Female ,business ,Child ,Anaphylaxis ,Desensitization (medicine) - Published
- 2015
21. Do Longer Intervals between Challenges Reduce the Risk of Adverse Reactions in Oral Wheat Challenges?
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Sakura Sato, Noriyuki Yanagida, Takanori Imai, and Motohiro Ebisawa
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Pediatrics ,medicine.medical_specialty ,Multidisciplinary ,Multivariate analysis ,business.industry ,lcsh:R ,lcsh:Medicine ,Retrospective cohort study ,medicine.disease ,Surgery ,Cardiovascular symptoms ,medicine ,Ingestion ,lcsh:Q ,business ,Adverse effect ,Challenge tests ,lcsh:Science ,Wheat allergy ,Anaphylaxis ,Research Article - Abstract
Background The use of oral food challenges (OFCs) in clinics is limited because they are complicated and associated with anaphylactic symptoms. To increase their use, it is necessary to develop novel, effective, and safe methods. However, the effectiveness of different OFCs has not been compared. Objective To investigate the effect of ingestion methods on wheat allergy symptoms and treatment during OFCs. Method Without changing the total challenge dose, we changed the administration method from a 5-installment dose titration every 15 min (15-min interval method) to 3 installments every 30 min (30-min interval method). We retrospectively reviewed and compared the results of 65 positive 15-min interval wheat challenge tests conducted between July 2005 and February 2008 and 87 positive 30-min interval tests conducted between March 2008 and December 2009. Results A history of immediate symptoms was more common for the 30-min interval method; however, no difference between methods was observed in other background parameters. Switching from the 15-min to the 30-min interval method did not increase symptoms or require treatment. The rate of cardiovascular symptoms (p = 0.032), and adrenaline use (p = 0.017) was significantly lower with the 30-min interval method. The results did not change after adjusting for the effects of immediate symptom history in multivariate analysis. Conclusion This study suggests that the 30-min interval method reduces the risk of adverse events, compared to the 15-min interval method.
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- 2015
22. Clinical studies in oral allergen-specific immunotherapy: differences among allergens
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Noriyuki Yanagida, Makiko Goto, Kiyotake Ogura, Yu Okada, Tomoyuki Asaumi, Akinori Syukuya, Sakura Sato, Katsuhito Iikura, Motohiro Ebisawa, Yumi Koike, Takanori Imai, and Tomohiro Utsunomiya
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Oral immunotherapy ,business.industry ,medicine.medical_treatment ,Immunology ,Specific immunotherapy ,Administration, Oral ,General Medicine ,Omalizumab ,Immunotherapy ,Allergens ,medicine.disease ,Clinical Practice ,Food allergy ,Desensitization, Immunologic ,Cohort ,medicine ,Immunology and Allergy ,Humans ,business ,Food Hypersensitivity ,medicine.drug ,Desensitization (medicine) - Abstract
Oral immunotherapy (OIT) is a significant focus of treatment of food allergy. OIT appears to be effective in inducing desensitization, however, patients receiving OIT frequently developmild/moderate symptoms during the therapy. It has not been clearly established whether the clinical tolerance induced by OIT resembles natural tolerance. According to our data, the efficacy of OIT is different among food antigens, and it is comparatively difficult to achieve the clinical tolerance in milk OIT. Moreover, the definitive evidence of efficacy and safety with long-term therapy is limited. Further studies need to be offered to patients in clinical practice. Recently, novel treatments for food allergy, sublingual and epicutaneous immunotherapy, and combination treatment with an anti-IgE monoclonal antibody (omalizumab), have been examined in some studies. OIT combined with omalizumab increased the threshold doses of food without adverse reactions and may be of benefit in food allergy treatment. More studies are needed to demonstrate long-term safety and treatment benefits in a larger patient cohort.
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- 2014
23. Care of children with allergic diseases following major disasters
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Takanori Imai, Takao Fujisawa, Takahide Teramoto, Naomi Kondo, Toshio Katsunuma, Katsushi Miura, Yuichi Adachi, Yukihiro Ohya, and Masaki Futamura
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Emergency Medical Services ,medicine.medical_specialty ,Immunology ,MEDLINE ,Disaster Planning ,Disasters ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Earthquakes ,Hypersensitivity ,Emergency medical services ,Humans ,Immunology and Allergy ,Medicine ,Interdisciplinary communication ,030212 general & internal medicine ,Cooperative Behavior ,Child ,business.industry ,medicine.disease ,030228 respiratory system ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Interdisciplinary Communication ,Cooperative behavior ,Medical emergency ,business ,Delivery of Health Care ,Disaster planning - Published
- 2016
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24. Japan Food Allergen Labeling Regulation—History and Evaluation
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Hiroshi Akiyama, Takanori Imai, and Motohiro Ebisawa
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Action levels ,business.industry ,Food allergy ,Prawn ,food and beverages ,Medicine ,Christian ministry ,Food allergens ,business ,medicine.disease ,Shrimp ,Biotechnology - Abstract
According to a national survey of food allergy cases, the food-labeling system for specific allergenic ingredients (i.e., egg, milk, wheat, buckwheat, and peanut) in Japan was mandated under law on April 1, 2002. By Japanese law, labeling of allergens is designated as mandatory or recommended based on the number of cases of actual illness and the degree of seriousness. Mandatory labeling is enforced by the ministerial ordinance, and the ministerial notification recommends that foods containing walnut and soybean be labeled with subspecific allergenic ingredients. Additional labeling of shrimp/prawn and crab has also become mandatory since 2008. To monitor the validity of the labeling system, the Japanese government announced the official methods for detection of allergens in a November 2002 ministry notification. These official methods, including two kinds of enzyme-linked immunosorbent assay kits for screening, Western blotting analyses for egg and milk, and polymerase chain reaction analyses for wheat, buckwheat, peanut, shrimp/prawn and crab as confirmation tests, have provided a means to monitor the labeling system. To standardize the official methods, the Japanese government described the validation protocol criteria in the 2006 official guidelines. The guidelines stipulate that any food containing allergen proteins at greater than 10mg/kg must be labeled under the Law. This review covers the selection of the specific allergenic ingredients by the Japanese government, the implementation of regulatory action levels and the detection methods to support them, and the assessment of the effectiveness of this approach.
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- 2011
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25. Nationwide Food Allergy Survey
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Takanori Imai, Y. Iikura, and A. Akasawa
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Allergy ,medicine.diagnostic_test ,biology ,business.industry ,Radioallergosorbent test ,Immunology ,General Medicine ,medicine.disease ,Immunoglobulin E ,medicine.disease_cause ,Allergen ,Food allergy ,Immunopathology ,medicine ,biology.protein ,Immunology and Allergy ,Adverse effect ,business ,Anaphylaxis - Abstract
We investigated cases of anaphylaxis caused by an adverse reaction to food from major hospitals with over 200 beds across the country. These cases showed anaphylactic symptoms within 60 min after the
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- 2001
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26. Basophil activation marker CD203c is useful in the diagnosis of hen's egg and cow's milk allergies in children
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Tomohiro Utsunomiya, Sakura Sato, Takatsugu Komata, Takanori Imai, Norimasa Kurosaka, Noriyuki Yanagida, Akinori Shukuya, Morimitsu Tomikawa, Masamichi Iguchi, Hiroshi Tachimoto, and Motohiro Ebisawa
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Male ,Allergy ,Immunology ,Milk allergy ,Basophil ,Ovomucin ,Sensitivity and Specificity ,Egg White ,Food allergy ,Predictive Value of Tests ,mental disorders ,medicine ,Immunology and Allergy ,Animals ,Humans ,Pyrophosphatases ,Child ,Egg Hypersensitivity ,Oral food challenge ,business.industry ,Phosphoric Diester Hydrolases ,musculoskeletal, neural, and ocular physiology ,digestive, oral, and skin physiology ,Caseins ,General Medicine ,Immunoglobulin E ,medicine.disease ,Basophils ,Basophil activation ,medicine.anatomical_structure ,Milk ,nervous system ,Egg allergy ,Area Under Curve ,Child, Preschool ,Cattle ,Female ,Milk Hypersensitivity ,business ,psychological phenomena and processes ,Egg white - Abstract
Background: The diagnosis of food allergy (FA) is usually based on oral food challenge tests (OFC). However, OFCs occasionally induce severe adverse reactions. CD203c expression on basophils is emerging as a potential diagnostic index. We evaluated whether CD203c expression on basophils would be a useful marker of OFC-associated symptoms in hen’s egg and cow’s milk allergies in children. Methods: Seventy-one patients who had been diagnosed with FA based on OFCs or a convincing history of FA symptoms in the Department of Pediatrics, Sagamihara National Hospital, were recruited. CD203c expression was assessed after stimulation with antigens (egg white, ovomucoid, milk or casein) using allergenicity kits. The CD203c stimulation index (SI = the allergen-induced CD203c expression level divided by the baseline expression level) and the threshold of CD203c expression (the minimum concentration of antigen to induce CD203c SI ≧2) were analyzed in association with tolerance acquisition. Results: For the CD203c SI, the areas under the receiver-operating characteristic curve were 0.72 for egg white, 0.82 for ovomucoid, 0.84 for milk and 0.67 for casein. The positive predictive value for the threshold of CD203c expression was 94.7% for egg white, 100% for ovomucoid, 85.7% for milk and 75.0% for casein. Conclusions: Assessment of food antigen-induced CD203c expression on basophils is useful to determine if children will outgrow FA as well as in decision making regarding whether or not to perform OFCs.
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- 2010
27. Management of neonatal cow's milk allergy in high-risk neonates
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Kazuo Itahashi, Takanori Imai, and Tokuo Miyazawa
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Enterocolitis ,Pediatrics ,medicine.medical_specialty ,Clinical tests ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Milk allergy ,medicine.disease ,Food protein-induced enterocolitis syndrome ,Japan ,Cow's milk allergy ,Infant, Extremely Low Birth Weight ,Health Care Surveys ,Pediatrics, Perinatology and Child Health ,Health care ,Medicine ,Humans ,Infant, Very Low Birth Weight ,Allergists ,medicine.symptom ,Milk Hypersensitivity ,business - Abstract
Background: We conducted a multicenter clinical survey to clarify the current attitudes to diagnosis or treatment of neonatal milk allergy (NMA) in institutions providing medical care for high-risk neonates in Japan. Methods: Questionnaires were distributed to 263 institutions that provide medical care for high-risk infants. Information was requested on the number of hospitalized neonates between January 2004 and December 2005, the number of neonates diagnosed with milk allergy, frequent clinical symptoms, and clinical tests performed routinely when NMA was suspected. Results: Responses were received from 145 institutions (55.1%). Of 69 796 hospitalized neonates, a diagnosis of cow's milk allergy was made in 0.21%. The incidence in infants with birthweight
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- 2009
28. The Safety of the Oral Food Challenge Test with the Small Amount of Wheat for the High Risk Patients
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Mayu Shimizu, Taro Kamiya, Toshinori Nakamura, Takanori Imai, and Kazuo Itahashi
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biology ,business.industry ,Oral food challenge ,Immunology ,Atopic dermatitis ,Basophil ,Immunoglobulin E ,medicine.disease ,medicine.disease_cause ,food.food ,Basophil activation ,food ,medicine.anatomical_structure ,Allergen ,Food allergy ,biology.protein ,Immunology and Allergy ,Medicine ,Food science ,business ,Brazil nut - Abstract
T U E S D A Y 810 Is the Allergen-Specific Basophil Activation Test (BAT) Predictive of Oral Food Challenge (OFC) Outcomes? Vijaya Knight, MD, PhD; National Jewish Health, Denver, CO. RATIONALE: Although specific IgE (sIgE) is the primary laboratory test for diagnosis of food allergy, some patients with elevated sIgEmay only be sensitized. The OFC carries many risks and challenges. This study was undertaken to determine whether an allergen induced BAT is more predictive of food allergy than sIgE/SPTand a potential surrogate for OFC. METHODS: BAT was performed on heparinized blood from patients undergoing OFC. Allergens included egg, milk, peanut, soy, wheat, almond, cashew, hazelnut, Brazil nut, walnut and pistachio. Allergenspecific upregulation of the basophil-specific ectoenzyme E-NPP3 (CD203c) was measured by flow cytometry. The extent of basophil activation, (fold increase of CD203c expression over baseline), was correlated with sIgE, SPT and OFC outcomes. RESULTS: 9 children underwent testing; 1 was excluded for inadequate response to positive control (anti-IgE). 57% demonstrated basophil reactivity to peanut; 43% egg; 40% pistachio, pecan, hazelnut, Brazil nut, cashew, and almond; 33% walnut; 29% milk and soy. Children with negative SPT or sIgE were not BAT positive, indicating good correlation for negative results. Two sensitized patients with negative BAT passed OFCs. CONCLUSIONS: This preliminary data demonstrates the utility of BAT in diagnosing food allergy. In this small cohort, specificity of the BAT appears equal, if not superior to sIgE and SPT in identification of patients with food allergy. The two patients with negative BAT passing OFC suggest that BAT could be used to guide the need for OFC. Recruitment to this study is ongoing. Further studies will focus on the BAT in select patient groups (e.g.; atopic dermatitis, high IgE).
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- 2015
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29. 496 Cross Sectional Study of 1,822 Pediatric Food Allergy Patients
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Takatsugu Komata, Tomohiro Utsunomiya, Akinori Shukuya, Katsuhito Iikura, Miho Hasegawa, Motohiro Ebisawa, Makiko Goto, Sakura Satou, Takanori Imai, Morimitsu Tomikawa, and Kiyotake Ogura
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Cross-sectional study ,digestive, oral, and skin physiology ,Immunology ,computer.software_genre ,medicine.disease ,Poster Session ,Abstracts of the XXII World Allergy Congress ,humanities ,Food allergy ,Family medicine ,Immunology and Allergy ,Medicine ,Data mining ,business ,computer - Abstract
Background The aim of this study is to clarify the cross section of pediatric food allergy patients. We investigated the profiles of food allergy (FA) patients seen in our department. Methods The number of food allergy patients seen in our department from January to December in 2010 was a total of 1,822 (male: 1207, female: 615, mean age: 5.8 ± 3.8 year). We collected and analyzed the clinical information of these patients from our medical record. We obtained information on the age of FA onset & FA diagnosis, clinical types of FA at the onset, causative food allergens, other allergic complications, and application of oral immunotherapy (OIT). Results The average age of FA onset was 8 months, and that of diagnosis was 1 year old, respectively. The most common clinical types of FA at the time of onset were infantile atopic dermatitis (AD) type with food allergy (66.4%) followed by immediate type (30.8%). Food allergens avoided by the patients were the total number of 4,203 items (2.1 items as average). The most common eliminated food was hen's egg (1,245 cases; 29.6%), followed by cow's milk (786 cases; 18.7%), peanut (449 cases; 10.7%), and wheat (407 cases; 9.7%). Food-dependent exercise-induced anaphylaxis (FDEIA) was the total of 18 cases, and the most common causative food for FDEIA was wheat (10 cases) followed by peach (4 cases). One hundred and seventy five cases (9.6%) were currently receiving OIT. Main causative foods under OIT were hen's egg (63 cases), cow's milk (80 cases), and wheat (30 cases). The average starting age of OIT was 7.1 years old. Regarding complications of allergic diseases other than FA, 1119 (61.4%) had atopic dermatitis, and 541 (29.7%) bronchial asthma. Conclusions We were able to clarify the cross section of food allergy patients in our department and to obtain the basic data to follow continuous transition of these patients.
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- 2012
30. 75 Efficacy of Slow Oral Immunotherapy for Cowʼs Milk Allergy
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Miho Hasegawa, Chizuko Sugizaki, Akinori Shukuya, Noriko Hayashi, Morimitsu Tomikawa, Motohiro Ebisawa, Makiko Goto, Sakura Satou, Takatsugu Komata, Takanori Imai, Katsuhito Iikura, Kiyotake Ogura, Tomohiro Utsunomiya, and Miki Satou
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Allergy ,Oral immunotherapy ,Oral food challenge ,business.industry ,Oral Abstract Session ,Initial dose ,Immunology ,Milk allergy ,medicine.disease ,Abstracts of the XXII World Allergy Congress ,Gastroenterology ,Asymptomatic ,Internal medicine ,medicine ,Immunology and Allergy ,Ingestion ,medicine.symptom ,business ,Anaphylaxis - Abstract
Background Efficacy and safety of slow oral immunotherapy (SOIT) is not yet clear, especially regarding tolerance acquisition. Methods We recruited 32 cow's milk (CM) allergy confirmed by oral food challenge (OFC). Twenty-five subjects were enrolled as SOIT group, and remaining 7 were as control. The inclusion criteria were as follows; (1) CM allergy without anaphylaxis confirmed by OFC just before the trial, and (2) children >4 years. In SOIT group, they were asked to take small amount of CM at home after the OFC. The initial dose was about 1/4 of the threshold eliciting positive objective symptoms, and it was built up to 200 mL CM depends on the symptoms (build up phase). After reaching 200 mL, they were asked to take 200 mL CM daily until the asymptomatic duration lasting for more than 3m (maintenance phase). The subjects, who completed maintenance phase, underwent OFC to confirm the tolerance acquisition after the cessation of CM ingestion for 2w (confirm-OFC). In control group, they had eliminated CM completely and underwent the confirm-OFC after 9.8 ± 2.9 m (mean ± SD). We investigated the endpoints (adverse reactions, medical treatments, results of confirm-OFC, and laboratory findings), prospectively. Results In SOIT group (n = 25) and control group (n = 7), the average age was 6.6y and 4.7y, respectively. The average threshold was 52 mL and 17 mL, and the CM specific IgE was 17.6 Ua/mL/9.9 Ua/mL, respectively. The average period of build up and maintenance phases in SOIT group was 80d (n = 25) and 98d (n = 15), respectively. The frequency of adverse reactions in all of build up (1973d) and maintenance phases (2924d) were 13.5% (mild symptoms)/2.3% (moderate symptoms) and 1.7% (mild)/0.3% (moderate), respectively. No patient had administered adrenaline during SOIT. Fifteen subjects in SOIT and 7 in control underwent the confirm-OFC. In SOIT, 8 subjects (53.3%) passed the confirm-OFC, whereas 2 (28.6%) passed in control. There was no statistically significant difference regarding tolerance acquisition between these 2 groups (P = 0.277). Conclusions This study suggests that SOIT for about 1/2 year induces desensitization effectively for CM allergy without severe adverse reactions. Further and longer study would be required to prove accelerated tolerance acquisition by SOIT.
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- 2012
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31. Summary of blinded-food challenges against hen's egg and cow's milk allergies in the past 11 years
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Sakura Sato, Morimitsu Tomikawa, Akinori Shukuya, Takanori Imai, Hiroshi Tachimoto, Mika Ogata, Takatsugu Komata, and Motohiro Ebisawa
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Pulmonary and Respiratory Medicine ,Allergy ,business.industry ,Environmental health ,Immunology ,Immunology and Allergy ,Medicine ,Food science ,business ,medicine.disease - Published
- 2007
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32. Food allergy and anaphylaxis – 2059. Mild symptoms induced by oral food challenge are not always associated with failed challenge results
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Morimitsu Tomikawa, Katsuhito Iikura, Akinori Shukuya, Takatsugu Komata, Noriyuki Yanagida, Motohiro Ebisawa, Takanori Imai, Taro Miura, Yumi Koike, Sakura Sato, and Kiyotake Ogura
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Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Abdominal pain ,Allergy ,Erythema ,business.industry ,Oral food challenge ,Immunology ,medicine.disease ,Mild symptoms ,Food allergy ,Meeting Abstract ,Immunology and Allergy ,Medicine ,medicine.symptom ,business ,Anaphylaxis - Abstract
Methods 4574 patients (average age 4.0 ± 2.6 years old, male-female ratio 1.89), who had received open-OFC to heated-egg or cow’s milk or wheat from 2005 to 2012, were enrolled to this study. Patients were divided into following 3 categories according to symptoms induced by OFC (primary diagnosis of FA). The “positive” group was patients who showed objective symptoms and “negative” group was patients who had not any symptoms. The third group was defined as “uncertain” who only showed subjective or weak objective symptoms such as slight erythema, mild abdominal pain or isolated cough. Patients with “negative” and “uncertain” group were asked to ingest causative foods or those products at home to confirm whether to induce any symptoms by the intake or not. In several weeks after OFC, we made the final diagnosis based on the information obtained from patients (final diagnosis of FA).
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- 2013
33. 482 Prospective Multicenter Survey of Cow's Milk Allergy in Nicu Neonates
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Y Ohtsuka, Kazuo Itabashi, Tokuo Miyazawa, M Kimura, and Takanori Imai
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Pediatrics ,medicine.medical_specialty ,Gastrointestinal bleeding ,business.industry ,Oral food challenge ,Perforation (oil well) ,Milk allergy ,medicine.disease ,Discontinuation ,nervous system ,Elimination diet ,Pediatrics, Perinatology and Child Health ,Medicine ,Anxiety ,medicine.symptom ,business ,psychological phenomena and processes ,Anaphylaxis - Abstract
Background and Aims Food hypersensitivity is a common cause of digestive symptoms in neonates. To confirm the diagnosis of neonatal cow’s milk allergy (CMA), an oral food challenge (OFC) test should be conducted. However, many neonatologists in Japan avoid OFC because of excessive anxiety regarding induction of severe symptoms and continue to feed babies therapeutic formula without an accurate diagnosis. We conducted a prospective multicenter survey in which the standardized OFC was required in neonates with mild symptoms suggesting CMA. Methods Neonates presenting with digestive symptoms suggesting CMA and who underwent OFC were enrolled between April 2010 and September 2011. Neonates with severe complications, inborn disorders or severe symptoms at the onset, such as anaphylaxis, mass gastrointestinal bleeding, or perforation, were excluded. This study was conducted as a multicenter survey of major NICUs in Japan. Results OFC was performed in 52 neonates and positive inductions of symptoms were seen in 23 (44%) of the challenged neonates. The majority had mild digestive symptoms which disappeared immediately after elimination of the causal milk. According to the results of OFC, the sensitivity, specificity, and positive predictive value of milk-specific IgE were 0%, 93%, and 0%, and those of the allergen-specific lymphocyte stimulation test were 61%, 76%, and 67%, respectively. Conclusions Diagnostic OFCs for CMA were safely carried out in neonates. The discontinuation of certain foods as part of an elimination diet can lead to appropriate nutrition management. In NICUs, OFC should be carried out more aggressively with careful observation.
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- 2012
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34. 436 Ten Years Follow up of Japanese Survey on Immediate Type Food Allergy
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Motohiro Ebisawa, Chizuko Sugizaki, and Takanori Imai
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,digestive, oral, and skin physiology ,Immunology ,Alternative medicine ,Poster Session ,Bioinformatics ,medicine.disease ,Abstracts of the XXII World Allergy Congress ,Food labeling ,Food allergy ,Environmental health ,medicine ,Immunology and Allergy ,Food allergens ,business - Abstract
Background The food labeling system for food allergens was introduced from April 2002 in Japan. To confirm the effectiveness of the system, we regularly conduct a nationwide food allergy survey every 3 years. Methods The survey was conducted in cooperation with over 1000 volunteer doctors in Japan at 2001+2002, 2005 and 2008. We have sent questionnaires to contributing doctors every 3 months based on the previous survey system, and contributing doctors were asked to report immediate type food allergy cases seen by those doctors. In this survey, immediate type food allergy was defined as the patients who had developed symptoms due to food allergic reaction within 60 minutes after intake of causative foods. The details of questionnaire consisted of age, sex, cause of food allergy, symptoms, antigen-specific IgE, and type of onset. Results A total of 8581 immediate type food allergy cases were reported by the doctors in these surveys. The most common causative foods were hen's egg (39.0%), milk products (18.0%), wheat products (9.4%), fruits (5.3%), crustacean (4.6%), peanuts (3.7%), fish egg, buckwheat and fish (3.6%). The most common clinical symptom was observed on skin (89.7%) followed by respiratory system (29.6%). Interestingly, the causes of food allergy were completely different from infancy (egg, milk, and wheat) to adulthood (wheat, crustacean and fruits). Anaphylactic shock was observed in 10.9% of the total reported cases. The cases of anaphylactic shock were due to hen's egg (27.1%), milk products (21.4%) and wheat (18.1%). Eleven percentages of patients had been hospitalized. Conclusions We could clarify the detail of the immediate type food allergy cases seen in Japan for a recent decade. Based on these data, countermeasures against food allergy have been conducted in collaboration with the Ministry of Health, Labour, and Welfare in Japan in order to improve quality of life of patients with food allergy.
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- 2012
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35. 492 Nationwide Survey of Immediate Type Food Allergy in Japan
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Motohiro Ebisawa, Chizuko Sugizaki, and Takanori Imai
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Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,business.industry ,digestive, oral, and skin physiology ,Immunology ,Alternative medicine ,medicine.disease ,Nationwide survey ,Poster Session ,Abstracts of the XXII World Allergy Congress ,Food labeling ,Food allergy ,Environmental health ,medicine ,Immunology and Allergy ,Food allergens ,business - Abstract
Background The food labeling system for food allergens was introduced from April 2002 in Japan. To confirm the effectiveness of the system, we regularly conduct a nationwide food allergy survey every 3 years. Methods The survey was conducted in cooperation with over 1000 volunteer allergists in Japan at 2001, 2002, 2005 and 2008. We sent questionnaire to contributing doctors every 3 months based on the past survey system, and contributing doctors were asked to report immediate type food allergy cases seen by those doctors. In this survey, immediate type food allergy was defined as the patients who had developed symptoms due to food allergic reaction within 60 minutes after intake of offending food. The details of questionnaire consisted of age, sex, cause of food allergy, symptoms, CAP system, and type of onset. Results A total of 8581 immediate type food allergy cases were reported by the doctors. The most common offending foods were hen's egg (39.0%), milk products (18.0%), wheat (9.4%), fruit (5.3%), crustacean (4.6%), peanuts (3.7%), fish egg, buckwheat and fish (3.6%). The most common clinical symptom was observed on skin (89.7%) followed by respiratory system (29.6%). Interestingly, the causes of food allergy were completely different from infancy (egg, milk, and wheat) to adulthood (wheat, crustacean and fruits). Anaphylactic shock was observed in 10.9% of the total reported cases. The cases of anaphylactic shock were due to hen's egg (27.1%), milk products (21.4%) and wheat (18.1%). Eleven percentages of patients had been hospitalized. Conclusions We revealed the current condition of the immediate type food allergy cases seen in Japan recent decade. Based on these data, countermeasures against food allergy are ongoing in collaboration with the Ministry of Health, Labour, and Welfare in Japan in order to improve quality of life of patients.
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- 2012
36. 429 Natural History of Food Allergy in Childhood -3 Years' Follow up of Pediatric Food Allergy Patients
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Sakura Satou, Takanori Imai, Miho Hasegawa, Tomohiro Utsunomiya, Akinori Shukuya, Makiko Goto, Kiyotake Ogura, Morimitsu Tomikawa, Katsuhito Iikura, Motohiro Ebisawa, and Takatsugu Komata
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pediatrics ,business.industry ,Immunology ,Alternative medicine ,medicine.disease ,Poster Session ,Abstracts of the XXII World Allergy Congress ,Natural history ,Food allergy ,medicine ,Immunology and Allergy ,business - Abstract
Background Food allergy (FA) is prevalent among children however natural history of FA is not fully clarified. Methods We sought to investigate the natural course of childhood FA. To follow up the transition of same patients, we collected clinical records of patients with 3 years’ interval from 2008 to 2010. Four hundred ninety-one patients (male 321 and female 170) were recruited to this study. Results The onset of FA was at the age of 5 months ± 1 year 3 month (mean ± SD). The clinical type at the onset was with infantile atopic eczema (84.1%), and followed by immediate reactions without eczema (14.9%). The initial diagnosis age was 10 months ± 1 year 4 months, and the first visit to our department was 1 year 11 month ± 2 years 5 months. Current age of the patients was 7 years 5 months ± 2 years 11 months, and 444 patients (90.4%) had experienced immediate reactions. The number of eliminated foods decreased from 2.4 ± 1.5 items/patient (n = 1191) to 1.9 ± 1.6 items/patient (n = 926) in 3 years. The ratio of stopping elimination of major allergens was 35.9% (121/337 patients) for hen's egg, 25.6% (52/203 patients) for cow's milk and 47.8% (44/92 patients) for wheat. Fourteen patients (2.9%) had developed new food allergies, and 2 of them had experienced anaphylaxis by tree nuts. Newly diagnosed allergens were only 0.1 ± 0.3 items/patient (n = 32), and nuts (n = 6) and peanut (n = 5) were the most frequent. Seventy-nine patients (16.1%) had developed complete remission of FA in 3 years, and 21.5% of them (17 patients) had never developed immediate reactions. Conclusions Most of pediatric FA started during infancy with atopic eczema, and developing tolerance is expected with aging. In some patients, persistent FA is troublesome for school age children.
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- 2012
37. Dolphin-Assisted Seawater Therapy for Severe Atopic Dermatitis: An Immunological and Psychological Study
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T. Matsuoka, M. Tomikawa, M. Utumi, Y. Iikura, Y. Sakamoto, K. Sugihara, L. Akai, and Takanori Imai
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Allergy ,Eosinophil cationic protein ,Bathing ,business.industry ,medicine.medical_treatment ,Immunology ,General Medicine ,Atopic dermatitis ,medicine.disease ,Atopy ,Immunopathology ,Immunology and Allergy ,Medicine ,Interleukin 8 ,business ,Hydrotherapy ,human activities - Abstract
We performed seawater therapy on atopic dermatitis patients for 6 days with dolphins. The presence of the dolphins seemed to alleviate the pain patients experienced while bathing in seawater. The skin condition improved dramatically, and immunologically, serum IL-8 levels decreased but MIP-1α and eosinophil cationic protein did not change.
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- 2001
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38. Treatment of Hen's Egg- and Cow's Milk-induced Anaphylaxis by Rash Oral Immunotherapy
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Noriyuki Yanagida, M. Iguchi, Takatsugu Komata, Morimitsu Tomikawa, Sakura Sato, Takanori Imai, Tomohiro Utsunomiya, and M. Ebisawa
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medicine.medical_specialty ,Oral immunotherapy ,business.industry ,Immunology ,medicine ,Immunology and Allergy ,medicine.symptom ,medicine.disease ,business ,Rash ,Dermatology ,Anaphylaxis - Published
- 2010
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39. Associations of functional NLRP3 polymorphisms with susceptibility to food-induced anaphylaxis and aspirin-induced asthma
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Yoichi Kohno, Akihiko Miyatake, Yuki Hitomi, Mayumi Tamari, Yoichi Suzuki, Naoki Shimojo, Masafumi Sakashita, Satoru Doi, Masami Taniguchi, Kimie Fujita, Tomomitsu Hirota, Takatsugu Komata, Noritaka Higashi, Michishige Harada, Morimitsu Tomikawa, Yusuke Nakamura, Tadao Enomoto, Motohiro Ebisawa, and Takanori Imai
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Male ,Linkage disequilibrium ,Genotype ,Immunology ,Single-nucleotide polymorphism ,Biology ,Polymorphism, Single Nucleotide ,Pyrin domain ,Aspirin-induced asthma ,Drug Hypersensitivity ,Gene Frequency ,Food allergy ,NLR Family, Pyrin Domain-Containing 3 Protein ,medicine ,Humans ,Immunology and Allergy ,Genetic Predisposition to Disease ,Child ,Anaphylaxis ,Alleles ,Aspirin ,integumentary system ,Haplotype ,Infant ,Exons ,medicine.disease ,Introns ,Haplotypes ,Child, Preschool ,Female ,Gene polymorphism ,Carrier Proteins ,Food Hypersensitivity - Abstract
Background NLR family, pyrin domain containing 3 (NLRP3), controls the activity of inflammatory caspase-1 by forming inflammasomes, which leads to cleavage of the procytokines IL-1β and IL-18. Recent studies have shown associations of human NLRP3 polymorphisms with susceptibility to various inflammatory diseases; however, the association with allergic diseases remains unclear. Objective We sought to examine whether NLRP3 polymorphisms are associated with susceptibility to food allergy, food-induced anaphylaxis, and aspirin-induced asthma (AIA). Methods We selected 15 tag single nucleotide polymorphisms (SNPs) of NLRP3 and conducted association analyses of NLRP3 using 574 and 1279 samples for food allergy and AIA, respectively. We further performed functional analyses of the susceptible SNPs. Results Two NLRP3 SNPs (rs4612666 and rs10754558) were significantly associated with susceptibility to food-induced anaphylaxis ( P = .00086 and P = .00068, respectively). The NLRP3 haplotype of the 2 SNPs also showed a significant association ( P = .000098). We could confirm the association with susceptibility to another hypersensitivity phenotype, AIA (rs4612666, P = .0096). Functional analysis revealed that the risk alleles of rs4612666 and rs10754558 increased the enhancer activity of NLRP3 expression and NLRP3 mRNA stability, respectively. Conclusion Our results indicate that the NLRP3 SNPs might play an important role in the development of food-induced anaphylaxis and AIA in a gain-of-function manner. Further research on the NLRP3 inflammasome will contribute to the development of novel diagnostic and therapeutic methods for food-induced anaphylaxis and AIA.
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- 2009
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40. SPT Is Superior To IgE CAPRAST For The Diagnosis Of Infantile Food Allergy
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M. Ogata, K. Ikematsu, M. Ebisawa, Hiroshi Tachimoto, Takatsugu Komata, C. Sugizaki, and Takanori Imai
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biology ,business.industry ,Food allergy ,Immunology ,biology.protein ,Immunology and Allergy ,Medicine ,business ,Immunoglobulin E ,medicine.disease - Published
- 2009
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41. Frequency of Immediate–Type Food Allergy in Children in Japan
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Kazunobu Fujita, Y. Imai, K. Koike, Yasurou Kohno, E. Iwasaki, Takanori Imai, H. Nakura, K. Hoshiyama, H. Okudaira, Yoji Iikura, and A. Akasawa
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medicine.medical_specialty ,Allergy ,Pediatrics ,business.industry ,Public health ,Immunology ,General Medicine ,Allergens ,medicine.disease ,Japan ,Food allergy ,Child, Preschool ,Surveys and Questionnaires ,Environmental health ,Immunopathology ,Epidemiology ,Humans ,Immunology and Allergy ,Medicine ,Sea food ,business ,Food Hypersensitivity - Published
- 1999
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42. Assessment of quality of life in children with food allergy
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Chizuko Sugizaki, Mika Ogata, Morimitsu Tomikawa, Noriko Minamitani, Takatsugu Komata, Hiroshi Tachimoto, Takanori Imai, and Motohiro Ebisawa
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Pulmonary and Respiratory Medicine ,Quality of life (healthcare) ,business.industry ,Food allergy ,Environmental health ,Immunology ,Immunology and Allergy ,Medicine ,business ,medicine.disease - Published
- 2007
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43. Usefulness of skin prick test using bifurcated needle for the diagnosis of food allergy among infantile atopic dermatitis
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Mika Ogata, Chizuko Sugisaki, Hiroshi Tachimoto, Morimitsu Tomikawa, Akinori Shukuya, Takanori Imai, Motohiro Ebisawa, Kaori Ikematsu, and Takashi Komata
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,business.industry ,Food allergy ,Immunology ,Immunology and Allergy ,Medicine ,Infantile atopic dermatitis ,Bifurcated needle ,business ,medicine.disease ,Dermatology ,Test (assessment) - Published
- 2007
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44. Leukotriene Receptor Antagonist May Prevent the Progression of Preschool Children Asthma
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M. Ebisawa, Morimitsu Tomikawa, Hiroshi Tachimoto, Takatsugu Komata, M. Ogata, Akinori Shukuya, and Takanori Imai
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Leukotriene receptor ,business.industry ,Immunology ,medicine ,Antagonist ,Immunology and Allergy ,medicine.disease ,business ,Asthma - Published
- 2006
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45. Retrospective Multicenter Survey on Food-Related Symptoms Suggestive of Cow’s Milk Allergy in NICU Neonates
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Tokuo Miyazawa, Kazuo Itabashi, and Takanori Imai
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lcsh:Immunologic diseases. Allergy ,Male ,Pediatrics ,medicine.medical_specialty ,Birth weight ,Milk allergy ,Food allergy ,Intensive Care Units, Neonatal ,Surveys and Questionnaires ,medicine ,cow’s milk allergy ,Immunology and Allergy ,Animals ,Humans ,Age of Onset ,Retrospective Studies ,Oral food challenge ,business.industry ,Incidence (epidemiology) ,Incidence ,Infant, Newborn ,Gestational age ,Infant ,Retrospective cohort study ,General Medicine ,medicine.disease ,gastrointestinal symptoms ,lymphocyte stimulation test ,Cattle ,Female ,Age of onset ,Milk Hypersensitivity ,gastrointestinal food allergy ,neonate ,business ,lcsh:RC581-607 ,Food Hypersensitivity - Abstract
Background Cow’s milk allergy (CMA) is one of the causes of gastrointestinal symptoms in neonates. A relationship between non-immunoglobulin (Ig) E mediated allergic reactions and CMA in early infancy has been proposed, but the clinical features and pathogenesis have not been established. The objective of this study is to determine the clinical characteristics of the neonates found in the earlier study to have food-related symptoms that suggested CMA. Methods A second questionnaire was sent to 53 NICUs, as a follow-up to the earlier study, to collect information on the background, onset age, clinical features, and results of clinical examinations. Results The median birth weight was 2614 g and the median gestational age was 36.9 weeks. Symptoms developed within 6 days after birth in 40% of cases. Gastrointestinal symptoms were seen in 90% of cases and were mainly vomiting, bloody stool and abdominal distention. A specific IgE test, a lymphocyte stimulation test, and a fecal eosinophil test were conducted in 88%, 23% and 55% of cases, respectively, and the positive rates were 30%, 84%, and 75%, respectively. An oral food challenge (OFC) test was performed in 26% for confirmation of the diagnosis. Conclusions We confirmed that the clinical manifestations of food-related symptoms suggestive of CMA in neonates were distinctly different from those of common immediate type food allergy and were largely affected by underlying factors such as prematurity and gastroenterological surgery. Further OFC-based prospective accumulation of cases of CMA in neonates will be particularly important to reveal the full clinical features of this disease.
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46. Food allergy and anaphylaxis – 2054. Easy-to-use severity grading system for treatment of symptoms induced by oral food challenge
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Morimitsu Tomikawa, Yumi Koike, Akinori Shukuya, Takatsugu Komata, Yuu Okada, Katsuhito Iikura, Noriyuki Yanagida, Ishida Wako, Takanori Imai, Hasegawa Yukiko, Taro Miura, Kiyotake Ogura, Motohiro Ebisawa, and Sakura Sato
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Gastrointestinal tract ,Allergy ,Oral food challenge ,business.industry ,Medical record ,Immunology ,Severity grading ,macromolecular substances ,medicine.disease ,medicine.anatomical_structure ,Food allergy ,Internal medicine ,Meeting Abstract ,medicine ,Immunology and Allergy ,business ,Anaphylaxis ,Respiratory tract - Abstract
Methods From June 2008 to June 2012, the severity of SR was assessed at double-blind placebo-controlled food challenge test (DBPCFC) to evaluate if they were candidates for rush oral immunotherapy or not. The medical records of 342 patients who showed positive reaction at DBPCFC were analyzed. A hundred and forty-one were allergic to hen’s egg, 156 to milk and 45 to wheat. We modified the grading system proposed by Sampson HA in 2003 to enhance the convenience at clinical practice. It was proposed to indicate “severity of SR for each organ system, i.e., skin, mucosa, gastrointestinal tract, respiratory tract, cardiovascular, and neurological system. Systemic reactions for each organ were classified as Grade (G) 1 (mild), G2 (moderate), and G3 (severe). The severity score was based on the organ system mostly affected. We examined relationship between the severity score and its treatment during DBPCFC.
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