Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104179
A. Nemni , V. Doyen
IgE-mediated food allergy prevalence is estimated at 10%. It varies depending on the regions of the globe, age, sex, the culprit food, ethnicity and allergic comorbidities or family history of atopy. The most frequent food allergenic trio are cow's milk, egg and peanut. Allergy to cow's milk proteins, the first allergy to appear during life and most often progressing towards recovery, has a prevalence, which varies from 0.54% to 1.38%. Egg allergy, estimated at 0.8%, comes in second place after cow's milk protein allergy, and are associated in 35% of the cases. Cooked forms are often well tolerated and lead to frequent healing. Peanut allergy prevalence varies from 0.93% to 1.9%, it appears early in life and is responsible for severe allergic reactions. It does not progress towards spontaneous tolerance and sensitization to nuts or the existence of early onset severe eczema are associated with a higher risk of persistent peanut allergy at the age of 6. The other foods most frequently involved are nuts, legumes, wheat, fish and seafood. Better epidemiological knowledge of food allergy and the contributing factors, severity factors and natural history leads to better care of patients with food allergy.
{"title":"Actualisation des données épidémiologiques sur l’allergie alimentaire vis-à-vis des « Big eight »","authors":"A. Nemni , V. Doyen","doi":"10.1016/j.reval.2024.104179","DOIUrl":"10.1016/j.reval.2024.104179","url":null,"abstract":"<div><div>IgE-mediated food allergy prevalence is estimated at 10%. It varies depending on the regions of the globe, age, sex, the culprit food, ethnicity and allergic comorbidities or family history of atopy. The most frequent food allergenic trio are cow's milk, egg and peanut. Allergy to cow's milk proteins, the first allergy to appear during life and most often progressing towards recovery, has a prevalence, which varies from 0.54% to 1.38%. Egg allergy, estimated at 0.8%, comes in second place after cow's milk protein allergy, and are associated in 35% of the cases. Cooked forms are often well tolerated and lead to frequent healing. Peanut allergy prevalence varies from 0.93% to 1.9%, it appears early in life and is responsible for severe allergic reactions. It does not progress towards spontaneous tolerance and sensitization to nuts or the existence of early onset severe eczema are associated with a higher risk of persistent peanut allergy at the age of 6. The other foods most frequently involved are nuts, legumes, wheat, fish and seafood. Better epidemiological knowledge of food allergy and the contributing factors, severity factors and natural history leads to better care of patients with food allergy.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104179"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104178
M. Guechchati, Z. Douhi, M. Soughi, S. Elloudi, H. Baybay, F.Z. Mernissi
{"title":"Cutaneous adverse reactions associated with SARS-CoV-2 vaccines (about 338 cases): Case series from the Dermatology Department of CHU Hassan II Fez","authors":"M. Guechchati, Z. Douhi, M. Soughi, S. Elloudi, H. Baybay, F.Z. Mernissi","doi":"10.1016/j.reval.2024.104178","DOIUrl":"10.1016/j.reval.2024.104178","url":null,"abstract":"","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 2","pages":"Article 104178"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104181
A.F. Santos , C. Riggioni , I. Agache , C.A. Akdis , M. Akdis , A. Alvarez-Perea , M. Alvaro-Lozano , B. Ballmer-Weber , S. Barni , K. Beyer , C. Bindslev-Jensen , H.A. Brough , B. Buyuktiryaki , D. Chu , S. Del Giacco , A. Dunn-Galvin , B. Eberlein , M. Ebisawa , P. Eigenmann , T. Eiwegger , I. Skypala
This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.
这份欧洲过敏与临床免疫学学会指南为诊断 IgE 介导的食物过敏提供了建议，并采用了建议、评估、发展和评价分级 (GRADE) 方法。食物过敏诊断首先要了解以过敏为重点的临床病史，然后通过检测确定 IgE 是否致敏，如血清过敏原特异性 IgE (sIgE)、皮肤点刺试验 (SPT) 和嗜碱性粒细胞活化试验 (BAT)（如有）。对任何可疑食物都应寻求 IgE 致敏的证据。SPT 和血清 sIgE 能很好地支持对某些食物（如花生和腰果）过敏的诊断，而对其他食物（如小麦和大豆）过敏的数据较少，检测效果也较差。对花生中的 Ara h 2、榛子中的 Cor a 14 和腰果中的 Ana o 3 等过敏原成分的 sIgE 检测有助于进一步支持诊断，尤其是对花粉过敏的个体。此外，还可使用花生和芝麻的 BAT。食物过敏诊断的参考标准是口服食物挑战（OFC）。对于不确定的病例应进行口腔食物挑战。出于实际考虑，大多数情况下都适合采用开放性食物挑战法。定期对食物过敏儿童进行过敏测试和/或 OFC 重新评估，可在其自发获得口服耐受性的情况下将食物重新纳入饮食。
{"title":"Traduction et republication de « Recommandations de l’EAACI sur le diagnostic de l’allergie alimentaire médiée par les IgE »","authors":"A.F. Santos , C. Riggioni , I. Agache , C.A. Akdis , M. Akdis , A. Alvarez-Perea , M. Alvaro-Lozano , B. Ballmer-Weber , S. Barni , K. Beyer , C. Bindslev-Jensen , H.A. Brough , B. Buyuktiryaki , D. Chu , S. Del Giacco , A. Dunn-Galvin , B. Eberlein , M. Ebisawa , P. Eigenmann , T. Eiwegger , I. Skypala","doi":"10.1016/j.reval.2024.104181","DOIUrl":"10.1016/j.reval.2024.104181","url":null,"abstract":"<div><div>This European Academy of Allergy and Clinical Immunology guideline provides recommendations for diagnosing IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Food allergy diagnosis starts with an allergy-focused clinical history followed by tests to determine IgE sensitization, such as serum allergen-specific IgE (sIgE) and skin prick test (SPT), and the basophil activation test (BAT), if available. Evidence for IgE sensitization should be sought for any suspected foods. The diagnosis of allergy to some foods, such as peanut and cashew nut, is well supported by SPT and serum sIgE, whereas there are less data and the performance of these tests is poorer for other foods, such as wheat and soya. The measurement of sIgE to allergen components such as Ara h 2 from peanut, Cor a 14 from hazelnut and Ana o 3 from cashew can be useful to further support the diagnosis, especially in pollen-sensitized individuals. BAT to peanut and sesame can be used additionally. The reference standard for food allergy diagnosis is the oral food challenge (OFC). OFC should be performed in equivocal cases. For practical reasons, open challenges are suitable in most cases. Reassessment of food allergic children with allergy tests and/or OFCs periodically over time will enable reintroduction of food into the diet in the case of spontaneous acquisition of oral tolerance.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104181"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104193
C. Braun
{"title":"Allergies alimentaires : défis et perspectives en 2025","authors":"C. Braun","doi":"10.1016/j.reval.2024.104193","DOIUrl":"10.1016/j.reval.2024.104193","url":null,"abstract":"","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104193"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104195
J. Subocz , T. Stoup , N. Just , C. Chenivesse
Asthma is a very common disease affecting young people in the age of working and therefore represents one of the leading diseases impacting occupational activity. Health condition of employees suffering from asthma is responsible for work productivity loss, through absenteeism and presenteeism, resulting among other things in significant indirect costs. Although only 10% of workers with asthma report asthma-related missing days of work throughout their live, mostly evoke a presenteeism (work attendance whereas work absence would be justified by health status). Severity and even more asthma control are the major determinants of asthma impact on work productivity. Improving asthma control through proper treatment leads to improved work productivity and reduced asthma-related costs. In severe asthma, biologics seem to reduce absenteeism but there is limited data about their effect on presenteeism.
{"title":"Impact de l’asthme sur le travail : une revue de la littérature","authors":"J. Subocz , T. Stoup , N. Just , C. Chenivesse","doi":"10.1016/j.reval.2024.104195","DOIUrl":"10.1016/j.reval.2024.104195","url":null,"abstract":"<div><div>Asthma is a very common disease affecting young people in the age of working and therefore represents one of the leading diseases impacting occupational activity. Health condition of employees suffering from asthma is responsible for work productivity loss, through absenteeism and presenteeism, resulting among other things in significant indirect costs. Although only 10% of workers with asthma report asthma-related missing days of work throughout their live, mostly evoke a presenteeism (work attendance whereas work absence would be justified by health status). Severity and even more asthma control are the major determinants of asthma impact on work productivity. Improving asthma control through proper treatment leads to improved work productivity and reduced asthma-related costs. In severe asthma, biologics seem to reduce absenteeism but there is limited data about their effect on presenteeism.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 2","pages":"Article 104195"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1016/j.reval.2024.104180
J. Goret , C. Klingebiel
{"title":"Commentaire méthodologique sur les recommandations EAACI sur le diagnostic des allergies alimentaires IgE-médiées : est-ce la fin du TPO et l’essor du TAB ?","authors":"J. Goret , C. Klingebiel","doi":"10.1016/j.reval.2024.104180","DOIUrl":"10.1016/j.reval.2024.104180","url":null,"abstract":"","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104180"},"PeriodicalIF":0.3,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-26DOI: 10.1016/j.reval.2024.104192
C. Braun , P. Bégin , A. Nosbaum
The strategy for preventing food allergies (FA) based on the early introduction of solid allergens appears insufficient, given the increasing incidence of FA despite changes in recommendations. The complementary strategy aimed at restoring the skin barrier by applying emollients has been studied for several years. Clinical studies evaluating the effectiveness of such strategy provided conflicting results, but the study protocols are highly heterogeneous: some emollients used are actually harmful to the skin barrier, while the frequency or area of application may be insufficient to have a positive impact on the skin barrier. These studies suggest that the application of an emollient with an acidic pH (around 5.5) and ideally ceramide-based would be beneficial in the primary prevention of FA. Additionally, it is important to avoid cosmetic products containing allergens, including food derivatives. These few simple advices can already be provided by primary care physicians.
预防食物过敏（FA）的策略是及早引入固体过敏原，尽管建议有所改变，但鉴于食物过敏的发病率仍在上升，这一策略似乎还不够。通过涂抹润肤剂来恢复皮肤屏障的补充策略已经研究了数年。评估这种策略有效性的临床研究提供了相互矛盾的结果，但研究方案差异很大：有些润肤剂实际上对皮肤屏障有害，而涂抹的频率或面积可能不足以对皮肤屏障产生积极影响。这些研究表明，使用酸性 pH 值（约 5.5）的润肤剂（最好是神经酰胺类）将有利于 FA 的一级预防。此外，避免使用含有过敏原（包括食品衍生物）的化妆品也很重要。这些简单的建议已经可以由初级保健医生提供。
{"title":"Stratégies ciblant la peau en prévention des allergies alimentaires","authors":"C. Braun , P. Bégin , A. Nosbaum","doi":"10.1016/j.reval.2024.104192","DOIUrl":"10.1016/j.reval.2024.104192","url":null,"abstract":"<div><div>The strategy for preventing food allergies (FA) based on the early introduction of solid allergens appears insufficient, given the increasing incidence of FA despite changes in recommendations. The complementary strategy aimed at restoring the skin barrier by applying emollients has been studied for several years. Clinical studies evaluating the effectiveness of such strategy provided conflicting results, but the study protocols are highly heterogeneous: some emollients used are actually harmful to the skin barrier, while the frequency or area of application may be insufficient to have a positive impact on the skin barrier. These studies suggest that the application of an emollient with an acidic pH (around 5.5) and ideally ceramide-based would be beneficial in the primary prevention of FA. Additionally, it is important to avoid cosmetic products containing allergens, including food derivatives. These few simple advices can already be provided by primary care physicians.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104192"},"PeriodicalIF":0.3,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.reval.2024.104174
A. Lemoine , S. Bamberger
Non-IgE-mediated food allergies are adverse immune reactions to certain food allergens that are specific for a given individual, but do not involve specific serum IgE antibodies. They mainly affect infants and young children. They include allergic proctocolitis, food protein-induced enterocolis syndrome (FPIES), allergic enteropathy, aspecific digestive dysmotility (e.g., severe reflux, constipation) and certain eosinophilic oesophagitis (EoE) responding to the avoidance diet. The most common allergen involved is cow's milk, but other foods may be responsible, particularly in breast-fed infants, although this is rare. The main symptoms are haematochezia in allergic proctocolitis, acute vomiting with pallor and hypotonia in FPIES, stunted growth and chronic diarrhoea in allergic enteropathy, and reflux with feeding difficulties in infantile EoE. Eviction-reintroduction of the suspected allergen is used as a diagnostic test in allergic proctocolitis and enteropathy. In FPIES, there is a clinical definition. For EoE, histological analysis of oesophageal biopsies makes the diagnosis after elimination of differential diagnoses. Treatment involves avoiding the allergen responsible until tolerance is acquired. With the exception of EoE, the course of the disease is favourable in the first 2–3 years of life. There is a risk of developing functional intestinal disorders and atopic diseases. EoE is a chronic disease, with possible cases of remission in paediatrics. The main complications are oesophageal stenosis, food impaction and oesophageal perforation.
{"title":"Histoire naturelle des allergies alimentaires non IgE-médiées","authors":"A. Lemoine , S. Bamberger","doi":"10.1016/j.reval.2024.104174","DOIUrl":"10.1016/j.reval.2024.104174","url":null,"abstract":"<div><div>Non-IgE-mediated food allergies are adverse immune reactions to certain food allergens that are specific for a given individual, but do not involve specific serum IgE antibodies. They mainly affect infants and young children. They include allergic proctocolitis, food protein-induced enterocolis syndrome (FPIES), allergic enteropathy, aspecific digestive dysmotility (e.g., severe reflux, constipation) and certain eosinophilic oesophagitis (EoE) responding to the avoidance diet. The most common allergen involved is cow's milk, but other foods may be responsible, particularly in breast-fed infants, although this is rare. The main symptoms are haematochezia in allergic proctocolitis, acute vomiting with pallor and hypotonia in FPIES, stunted growth and chronic diarrhoea in allergic enteropathy, and reflux with feeding difficulties in infantile EoE. Eviction-reintroduction of the suspected allergen is used as a diagnostic test in allergic proctocolitis and enteropathy. In FPIES, there is a clinical definition. For EoE, histological analysis of oesophageal biopsies makes the diagnosis after elimination of differential diagnoses. Treatment involves avoiding the allergen responsible until tolerance is acquired. With the exception of EoE, the course of the disease is favourable in the first 2–3 years of life. There is a risk of developing functional intestinal disorders and atopic diseases. EoE is a chronic disease, with possible cases of remission in paediatrics. The main complications are oesophageal stenosis, food impaction and oesophageal perforation.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 1","pages":"Article 104174"},"PeriodicalIF":0.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.1016/j.reval.2024.104176
D.G. Ebo , A. Toscano , H.-P. Rihs , C. Mertens , V. Sabato , J. Elst , M. Beyens , M.M. Hagendorens , M. Van Houdt , A.L. Van Gasse
With the expansion of access to cannabis and the decriminalization of its use, cases of IgE-dependent cannabis allergy and cannabis-associated food syndromes have been increasingly reported. However, the exact prevalence of cannabis allergy and associated cross-reactivity syndromes remains unknown and is likely to be underestimated due to a lack of awareness and knowledge of the subject among healthcare professionals. This practical roadmap therefore aims to familiarize readers with the early recognition and correct management of cannabis-related IgE-dependent allergies. The aim is to understand the mechanisms underlying these cross-reactivity syndromes and to enable personalised diagnosis and management. Although there are as yet no commercially available molecular cannabis allergens, a more personalized approach can be achieved by using homologs and the recombinant Can s 3 (non-specific lipid transfer protein) available as a research allergen. The predominant symptoms of cannabis allergy are rhinoconjunctivitis and contact urticaria/angioedema, but severe life-threatening anaphylaxis is also possible, as well as cross-food allergy syndromes, mainly involving fruit, vegetables, nuts and cereals. At present, diagnosis generally begins with prick tests using buds, leaves or seeds of the cannabis plant. The road to a clear understanding of food allergy and the cross-reactive food syndromes associated with it is still long and winding, but it deserves to be explored further.
随着大麻使用范围的扩大和大麻使用的非刑罪化，IgE 依赖性大麻过敏和大麻相关食物综合征病例的报道越来越多。然而，大麻过敏和相关交叉反应综合征的确切发病率仍是未知数，而且由于医护人员对这一问题缺乏认识和了解，其发病率很可能被低估。因此，本实用指南旨在让读者了解如何早期识别和正确处理与大麻相关的 IgE 依赖性过敏。其目的是了解这些交叉反应综合征的内在机制，实现个性化诊断和管理。虽然目前还没有商业化的分子大麻过敏原，但通过使用同源物和作为研究过敏原的重组 Can s 3（非特异性脂质转移蛋白），可以实现更加个性化的方法。大麻过敏的主要症状是鼻结膜炎和接触性荨麻疹/水肿，但也可能出现危及生命的严重过敏性休克，以及交叉食物过敏综合征，主要涉及水果、蔬菜、坚果和谷物。目前，诊断一般从使用大麻植物的花蕾、叶子或种子进行点刺试验开始。要清楚地了解食物过敏和与之相关的交叉反应食物综合症，道路依然漫长而曲折，但值得我们进一步探索。
{"title":"L’allergie au cannabis et les syndromes de réactivité croisée : une feuille de route pour un diagnostic et une prise en charge corrects","authors":"D.G. Ebo , A. Toscano , H.-P. Rihs , C. Mertens , V. Sabato , J. Elst , M. Beyens , M.M. Hagendorens , M. Van Houdt , A.L. Van Gasse","doi":"10.1016/j.reval.2024.104176","DOIUrl":"10.1016/j.reval.2024.104176","url":null,"abstract":"<div><div>With the expansion of access to cannabis and the decriminalization of its use, cases of IgE-dependent cannabis allergy and cannabis-associated food syndromes have been increasingly reported. However, the exact prevalence of cannabis allergy and associated cross-reactivity syndromes remains unknown and is likely to be underestimated due to a lack of awareness and knowledge of the subject among healthcare professionals. This practical roadmap therefore aims to familiarize readers with the early recognition and correct management of cannabis-related IgE-dependent allergies. The aim is to understand the mechanisms underlying these cross-reactivity syndromes and to enable personalised diagnosis and management. Although there are as yet no commercially available molecular cannabis allergens, a more personalized approach can be achieved by using homologs and the recombinant Can s 3 (non-specific lipid transfer protein) available as a research allergen. The predominant symptoms of cannabis allergy are rhinoconjunctivitis and contact urticaria/angioedema, but severe life-threatening anaphylaxis is also possible, as well as cross-food allergy syndromes, mainly involving fruit, vegetables, nuts and cereals. At present, diagnosis generally begins with prick tests using buds, leaves or seeds of the cannabis plant. The road to a clear understanding of food allergy and the cross-reactive food syndromes associated with it is still long and winding, but it deserves to be explored further.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 2","pages":"Article 104176"},"PeriodicalIF":0.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.reval.2024.104177
S. Aminou, S. Benchekroun, N. El Hafidi, C. Mahraoui
Selective hypersensitivity to clavulanic acid is continuously increasing in recent decades due to the increase in its consumption. The allergological work-up is complex, mainly based on clinical history, followed by skin testing, and drug provocation test. The low sensitivity of in vitro tests is explained by the fact that clavulanic acid is highly metabolised into different products, with heterogeneous immunogenicities, being only some of them optimally recognised by the immune system. We report the case of a young girl who received one tablet of amoxicillin-clavulanic acid and developed immediate anaphylaxis, although she had previously tolerated amoxicillin. Immediate-reading skin tests performed with amoxicillin and cephalosporins were negative. A selective allergy to clavulanic acid was diagnosed by a positive response in skin tests with amoxicillin-clavulanic acid and tolerance of a provocation test with amoxicillin. No cross-reactivity was recorded between clavulanic acid and others beta-lactams.
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