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Joachim Saloga - One of the best experts on this subject based on the ideXlab platform.
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guideline on management of suspected adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the society for pediatric Allergology and environmental medicine gpa the medical association of german allergologists aeda as well as the swiss society for Allergology and immunology sgai and the austrian society for Allergology and immunology ogai
Allergologie select, 2021Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Ludger Klimek, Ute Lepp, Joachim Saloga, Sabine Dollebierke, Sonja Lammel, Christiane SchaferAbstract:Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (OGAI) recommends a practicable diagnostic and therapeutic approach.
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german guideline for the management of adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the german society for pediatric Allergology and environmental medicine gpa the german associ
Allergo journal international, 2017Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Thomas Fuchs, Ludger Klimek, Ute Lepp, Bodo Niggemann, Joachim Saloga, Christiane SchaferAbstract:Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the "Food Allergy" Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
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approach to suspected food allergy in atopic dermatitis guideline of the task force on food allergy of the german society of Allergology and clinical immunology dgaki and the medical association of german allergologists ada and the german society of
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Thomas Werfel, Jorg Kleinetebbe, Imke Reese, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, Margot Henzgen, M Raithel, Joachim SalogaAbstract:Summary The following guideline of the “Arbeitsgruppe Nahrungsmittelallergie der DGAKI” (Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology) and the ADA (“Arzteverband Deutscher Allergologen”, Medical Association of German Allergologists) and the GPA (German Society of Pediatric Allergology) summarizes the approach to be taken when food allergy is suspected in patients with atopic dermatitis (neurodermatitis, atopic eczema). The problem is clinically relevant because many patients assume that allergic reactions against foods are responsible for triggering or worsening their eczema. It is important to identify those patients who will benefit from an elimination diet but also to avoid unnecessary diets. Elimination diets (especially in early childhood) are associated with the risk of malnutrition and additional emotional stress for the patients. The gold standard for the diagnosis of food-dependent reactions is to perform placebo-controlled, double-blind oral food challenges because specific IgE, prick tests and history often do not correlate with clinical reactivity. This is particularly true in the case of delayed eczematous skin reactions. Diagnostic elimination diets should be used before an oral provocation test. If multiple sensitizations against foods are discovered in a patient, an oligoallergenic diet and a subsequent stepwise supplementation of the nutrition should be performed. If a specific food is suspected of triggering food allergy, oral provocation should be performed after a diagnostic elimination diet. As eczema-tous skin reactions may develop slowly (i. e. within one or two day), the skin be inspected the day after the provocation test and that a repetitive test be performed if the patient has not reacted to a given food on the first day of oral provocation. The guideline discusses various clinical situations for patients with atopic dermatitis to facilitate differentiated diagnostic procedures.
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skin testing with food allergens guideline of the german society of Allergology and clinical immunology dgaki the physicians association of german allergologists ada and the soc
Journal Der Deutschen Dermatologischen Gesellschaft, 2008Co-Authors: Margot Henzgen, Imke Reese, Barbara Ballmerweber, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, M Raithel, Jorg Kleinetebbe, Joachim SalogaAbstract:Summary Skin testing has a central role in the diagnosis of food allergy. Prick testing is well- established as a routine diagnostic tool. Nonetheless, unstable allergens and the lack of standardized extracts create difficulties in the identification of sensitization to foods in patients with suspected food allergy. Therefore prick-to-prick tests with native (raw, fresh) foods are still recommended. The indications and contraindications are the same as those of routine skin testing in clinical Allergology. We recommend a careful and restricted application of skin tests in patients with a history of severe anaphylaxis to foods.
Bodo Niggemann - One of the best experts on this subject based on the ideXlab platform.
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german guideline for the management of adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the german society for pediatric Allergology and environmental medicine gpa the german associ
Allergo journal international, 2017Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Thomas Fuchs, Ludger Klimek, Ute Lepp, Bodo Niggemann, Joachim Saloga, Christiane SchaferAbstract:Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the "Food Allergy" Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
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approach to suspected food allergy in atopic dermatitis guideline of the task force on food allergy of the german society of Allergology and clinical immunology dgaki and the medical association of german allergologists ada and the german society of
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Thomas Werfel, Jorg Kleinetebbe, Imke Reese, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, Margot Henzgen, M Raithel, Joachim SalogaAbstract:Summary The following guideline of the “Arbeitsgruppe Nahrungsmittelallergie der DGAKI” (Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology) and the ADA (“Arzteverband Deutscher Allergologen”, Medical Association of German Allergologists) and the GPA (German Society of Pediatric Allergology) summarizes the approach to be taken when food allergy is suspected in patients with atopic dermatitis (neurodermatitis, atopic eczema). The problem is clinically relevant because many patients assume that allergic reactions against foods are responsible for triggering or worsening their eczema. It is important to identify those patients who will benefit from an elimination diet but also to avoid unnecessary diets. Elimination diets (especially in early childhood) are associated with the risk of malnutrition and additional emotional stress for the patients. The gold standard for the diagnosis of food-dependent reactions is to perform placebo-controlled, double-blind oral food challenges because specific IgE, prick tests and history often do not correlate with clinical reactivity. This is particularly true in the case of delayed eczematous skin reactions. Diagnostic elimination diets should be used before an oral provocation test. If multiple sensitizations against foods are discovered in a patient, an oligoallergenic diet and a subsequent stepwise supplementation of the nutrition should be performed. If a specific food is suspected of triggering food allergy, oral provocation should be performed after a diagnostic elimination diet. As eczema-tous skin reactions may develop slowly (i. e. within one or two day), the skin be inspected the day after the provocation test and that a repetitive test be performed if the patient has not reacted to a given food on the first day of oral provocation. The guideline discusses various clinical situations for patients with atopic dermatitis to facilitate differentiated diagnostic procedures.
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skin testing with food allergens guideline of the german society of Allergology and clinical immunology dgaki the physicians association of german allergologists ada and the soc
Journal Der Deutschen Dermatologischen Gesellschaft, 2008Co-Authors: Margot Henzgen, Imke Reese, Barbara Ballmerweber, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, M Raithel, Jorg Kleinetebbe, Joachim SalogaAbstract:Summary Skin testing has a central role in the diagnosis of food allergy. Prick testing is well- established as a routine diagnostic tool. Nonetheless, unstable allergens and the lack of standardized extracts create difficulties in the identification of sensitization to foods in patients with suspected food allergy. Therefore prick-to-prick tests with native (raw, fresh) foods are still recommended. The indications and contraindications are the same as those of routine skin testing in clinical Allergology. We recommend a careful and restricted application of skin tests in patients with a history of severe anaphylaxis to foods.
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suggestions for a uniform terminology in Allergology and pneumology
Pediatric Allergy and Immunology, 2008Co-Authors: Bodo NiggemannAbstract:As authors tend to use different terms for the same entity or meaning, it may be the time for a uniformly use terminology in Allergology and pneumology. The proposals reflect personal suggestions and are not authorized by any consensus conference, task force or specialized society. Presented are proposals for concepts- it was not intended to give definitions, which would open an even broader field of differing opinions. To avoid misunderstandings and to standardize scientific language, it seems sensible to agree on a single term - even if several alternatives are possible.
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how can we improve compliance in pediatric pneumology and Allergology
Allergy, 2005Co-Authors: Bodo NiggemannAbstract:Not too long ago, physicians took 'compliance' or 'adherence' to mean the strict obedience of patients and parents - doing what the physician said, suggesting that the success or failure of the treatment lay entirely in the hands of the patient. But it is preferable to improve compliance rather than enforce it. As there is no single solution that will ensure compliance, several steps should be taken: (i) 'exploration' includes open questions, and allows admission of non-compliance, e.g. in terms of failure to take drugs, or smoking; (ii) 'education' means explaining pathomechanisms, and reducing corticophobia; (iii) 'tailoring' is reached by focussing therapeutic options on individual requirements, and simplifying treatment regimens; (iv) 'contracting' involves negotiating a realistic therapeutic regimen on an individual basis; (v) 'reminders' are practical tips, which may help to overcome reluctance, e.g. by placing drugs in the toothbrush glass, and on the breakfast table, or in the sports bag; (vi) 'follow-up' ensures long-term compliance, with regular visits to the physician, and self-management programmes. In conclusion, non-compliance of patients and parents is a challenging problem in daily practice. Including the aspects of the abovementioned factors can help build up a relation of trust and partnership, which is the prerequisite of any therapeutic success. However, this is an ongoing process, which has to be continuously reviewed.
P Demoly - One of the best experts on this subject based on the ideXlab platform.
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the roadmap for Allergology in europe the european training requirements for the specialty of Allergology
Allergy, 2021Co-Authors: Roy Gerth Van Wijk, Norbert Mülleneisen, P Demoly, Todor A Popov, Peter Schmidgrendelmeier, J M Olaguibel, Olympia TsilochristouAbstract:The development of the European training requirements (ETR) for medical specialties in Europe is regulated by the Union Europeenne des Medecins Specialistes (UEMS), a non-governmental organisation representing national associations of medical specialists at European Level. The training requirements of the specialty of Allergology were developed in 1994, amended in 1997, 2001, 2002 and 2003 and published in 2004 (1) . Seventeen years after, we present an update of the ETR for the specialty of Allergology as approved by the UEMS Council held 18 October 2019 in London.
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how molecular Allergology can shape the management of allergic airways diseases
Current Opinion in Allergy and Clinical Immunology, 2020Co-Authors: Davide Caimmi, Enrica Manca, Elena Carboni, P DemolyAbstract:PURPOSE OF REVIEW In allergy, personalized medicine passes through the assessment of molecular allergens sensitization profiles. Such technique may help to better diagnose and treat patients suffering from allergic respiratory diseases. RECENT FINDINGS Different laboratory tests are available today to assess sensitization to molecular allergens, from singleplex assays, to unspecific, screening multiplex assays, mainly performed through microarrays or macroarrays. It is important to collect both results from specific IgE toward allergen extracts and toward molecular allergens, to collect the most complete information on the patient's profile, and therefore to highlight genuine sensitization, and exclude cross-reaction and sensitization because of pan-allergens. Being able to know the exact molecular sensitization profile of the patient, also helps predicting the possible evolution of the disease, and targeting the most appropriate allergen immunotherapy treatment to prescribe. SUMMARY Even though a cost-effective analysis of running multiple assays in allergic patients has not been performed yet, such technique proved to be more efficient in detecting the appropriate treatment in each patient and in analyzing the true sensitization profile in patients suffering from allergic rhinitis, conjunctivitis, and asthma.
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Allergology in europe the blueprint
Allergy, 2013Co-Authors: J G R De Monchy, P Demoly, Peter Schmidgrendelmeier, Cezmi A Akdis, Victoria Cardona, Nikolaos G Papadopoulos, J GayraudAbstract:The number of patients with allergic diseases in Europe, and thus relevant demand for health care, is continuously increasing. In this EAACI-UEMS position paper, a rationale is given for the medical specialty of Allergology. General practitioners and general paediatricians usually cannot elucidate and address all causative factors. Throughout Europe, therefore, the expertise of allergologists (allergists) is required. In collaboration with other medical professionals, they take care of allergic patients, in private practices or in specialized public centres. A well-structured collaboration between allergists and allergy centres offers the possibility of rapid signalling of new trends developing in the population of allergic patients (e.g., in food and drug allergy). Allergy centres also can perform clinical (and basic) research, teach medical students, future allergists and provide postgraduate training. To prevent that the quality of care in one or several countries within Europe lags behind developments in other countries, the UEMS Section and Board on Allergology together with the European Academy of Allergy and Clinical Immunology advocates the status of a full specialty of Allergology in each European country, with a further intention to align their activities (blueprint, curriculum and centre visitation) with the UEMS Section of Paediatrics.
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reducing the risk of anaphylaxis during anesthesia 2011 updated guidelines for clinical practice
Journal of Investigational Allergology and Clinical Immunology, 2011Co-Authors: P M Mertes, J M Malinovsky, L Jouffroy, Werner Aberer, Ingrid Terreehorst, Knut Brockow, P DemolyAbstract:These guidelines represent the updated consensus of experts in the field of immediate hypersensitivity reactions occurring during anesthesia. They provide a series of valid, widely accepted, effective, and easily teachable guidelines that are the fruit of current knowledge, research, and experience. The guidelines are based on the findings of international scientific research and have been implemented in France under the auspices of the French Society for Anaesthesia and Intensive Care (Societe Francaise d'Anesthesie et de Reanimation [SFAR]) and the French Society of Allergology (Societe Francaise d'Allergologie [SFA]). The members of the European Network for Drug Allergy approved the guidelines. This paper presents the most relevant clinical implications of the guidelines.
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general considerations for skin test procedures in the diagnosis of drug hypersensitivity
Allergy, 2002Co-Authors: Knut Brockow, Antonino Romano, Miguel Blanca, J Ring, Werner J Pichler, P DemolyAbstract:K. Brockow, A. Romano, M. Blanca, J. Ring, W. Pichler, P. Demoly Klinik und Poliklinik fur Dermatologie und Allergologie, Muenchen, Germany; Department of Internal Medicine and Geriatrics, UCSC, Allergy Unit, CI Columbus, Rome and IRCS Oasi Maria SS, Troina, Italy; Research Unit for Allergic Diseases, Carlos Haya Hospital, Malaga, Spain; Clinic for Rheumatology and Clinical Immunology/Allergology, Inselspital, Bern, Switzerland; Maladies Respiratoires, Hopital Arnaud de Villeneuve, Montpellier, France
Imke Reese - One of the best experts on this subject based on the ideXlab platform.
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guideline on management of suspected adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the society for pediatric Allergology and environmental medicine gpa the medical association of german allergologists aeda as well as the swiss society for Allergology and immunology sgai and the austrian society for Allergology and immunology ogai
Allergologie select, 2021Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Ludger Klimek, Ute Lepp, Joachim Saloga, Sabine Dollebierke, Sonja Lammel, Christiane SchaferAbstract:Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (OGAI) recommends a practicable diagnostic and therapeutic approach.
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german guideline for the management of adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the german society for pediatric Allergology and environmental medicine gpa the german associ
Allergo journal international, 2017Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Thomas Fuchs, Ludger Klimek, Ute Lepp, Bodo Niggemann, Joachim Saloga, Christiane SchaferAbstract:Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the "Food Allergy" Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
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approach to suspected food allergy in atopic dermatitis guideline of the task force on food allergy of the german society of Allergology and clinical immunology dgaki and the medical association of german allergologists ada and the german society of
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Thomas Werfel, Jorg Kleinetebbe, Imke Reese, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, Margot Henzgen, M Raithel, Joachim SalogaAbstract:Summary The following guideline of the “Arbeitsgruppe Nahrungsmittelallergie der DGAKI” (Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology) and the ADA (“Arzteverband Deutscher Allergologen”, Medical Association of German Allergologists) and the GPA (German Society of Pediatric Allergology) summarizes the approach to be taken when food allergy is suspected in patients with atopic dermatitis (neurodermatitis, atopic eczema). The problem is clinically relevant because many patients assume that allergic reactions against foods are responsible for triggering or worsening their eczema. It is important to identify those patients who will benefit from an elimination diet but also to avoid unnecessary diets. Elimination diets (especially in early childhood) are associated with the risk of malnutrition and additional emotional stress for the patients. The gold standard for the diagnosis of food-dependent reactions is to perform placebo-controlled, double-blind oral food challenges because specific IgE, prick tests and history often do not correlate with clinical reactivity. This is particularly true in the case of delayed eczematous skin reactions. Diagnostic elimination diets should be used before an oral provocation test. If multiple sensitizations against foods are discovered in a patient, an oligoallergenic diet and a subsequent stepwise supplementation of the nutrition should be performed. If a specific food is suspected of triggering food allergy, oral provocation should be performed after a diagnostic elimination diet. As eczema-tous skin reactions may develop slowly (i. e. within one or two day), the skin be inspected the day after the provocation test and that a repetitive test be performed if the patient has not reacted to a given food on the first day of oral provocation. The guideline discusses various clinical situations for patients with atopic dermatitis to facilitate differentiated diagnostic procedures.
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skin testing with food allergens guideline of the german society of Allergology and clinical immunology dgaki the physicians association of german allergologists ada and the soc
Journal Der Deutschen Dermatologischen Gesellschaft, 2008Co-Authors: Margot Henzgen, Imke Reese, Barbara Ballmerweber, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, M Raithel, Jorg Kleinetebbe, Joachim SalogaAbstract:Summary Skin testing has a central role in the diagnosis of food allergy. Prick testing is well- established as a routine diagnostic tool. Nonetheless, unstable allergens and the lack of standardized extracts create difficulties in the identification of sensitization to foods in patients with suspected food allergy. Therefore prick-to-prick tests with native (raw, fresh) foods are still recommended. The indications and contraindications are the same as those of routine skin testing in clinical Allergology. We recommend a careful and restricted application of skin tests in patients with a history of severe anaphylaxis to foods.
Ute Lepp - One of the best experts on this subject based on the ideXlab platform.
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guideline on management of suspected adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the society for pediatric Allergology and environmental medicine gpa the medical association of german allergologists aeda as well as the swiss society for Allergology and immunology sgai and the austrian society for Allergology and immunology ogai
Allergologie select, 2021Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Ludger Klimek, Ute Lepp, Joachim Saloga, Sabine Dollebierke, Sonja Lammel, Christiane SchaferAbstract:Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (OGAI) recommends a practicable diagnostic and therapeutic approach.
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german guideline for the management of adverse reactions to ingested histamine guideline of the german society for Allergology and clinical immunology dgaki the german society for pediatric Allergology and environmental medicine gpa the german associ
Allergo journal international, 2017Co-Authors: Imke Reese, Jorg Kleinetebbe, Barbara Ballmerweber, Kirsten Beyer, Thomas Fuchs, Ludger Klimek, Ute Lepp, Bodo Niggemann, Joachim Saloga, Christiane SchaferAbstract:Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the trigger of their symptoms. The scientific evidence to support the postulated link between ingestion of histamine and adverse reactions is limited, and a reliable laboratory test for objective diagnosis is lacking. This position paper by the "Food Allergy" Working Group of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Association of Allergologists (AeDA), the Society for Pediatric Allergology and Environmental Medicine (GPA), and the Swiss Society for Allergology and Immunology (SGAI) reviews the data on the clinical picture of adverse reactions to ingested histamine, summarizes important aspects and their consequences, and proposes a practical diagnostic and therapeutic approach.
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approach to suspected food allergy in atopic dermatitis guideline of the task force on food allergy of the german society of Allergology and clinical immunology dgaki and the medical association of german allergologists ada and the german society of
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Thomas Werfel, Jorg Kleinetebbe, Imke Reese, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, Margot Henzgen, M Raithel, Joachim SalogaAbstract:Summary The following guideline of the “Arbeitsgruppe Nahrungsmittelallergie der DGAKI” (Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology) and the ADA (“Arzteverband Deutscher Allergologen”, Medical Association of German Allergologists) and the GPA (German Society of Pediatric Allergology) summarizes the approach to be taken when food allergy is suspected in patients with atopic dermatitis (neurodermatitis, atopic eczema). The problem is clinically relevant because many patients assume that allergic reactions against foods are responsible for triggering or worsening their eczema. It is important to identify those patients who will benefit from an elimination diet but also to avoid unnecessary diets. Elimination diets (especially in early childhood) are associated with the risk of malnutrition and additional emotional stress for the patients. The gold standard for the diagnosis of food-dependent reactions is to perform placebo-controlled, double-blind oral food challenges because specific IgE, prick tests and history often do not correlate with clinical reactivity. This is particularly true in the case of delayed eczematous skin reactions. Diagnostic elimination diets should be used before an oral provocation test. If multiple sensitizations against foods are discovered in a patient, an oligoallergenic diet and a subsequent stepwise supplementation of the nutrition should be performed. If a specific food is suspected of triggering food allergy, oral provocation should be performed after a diagnostic elimination diet. As eczema-tous skin reactions may develop slowly (i. e. within one or two day), the skin be inspected the day after the provocation test and that a repetitive test be performed if the patient has not reacted to a given food on the first day of oral provocation. The guideline discusses various clinical situations for patients with atopic dermatitis to facilitate differentiated diagnostic procedures.
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skin testing with food allergens guideline of the german society of Allergology and clinical immunology dgaki the physicians association of german allergologists ada and the soc
Journal Der Deutschen Dermatologischen Gesellschaft, 2008Co-Authors: Margot Henzgen, Imke Reese, Barbara Ballmerweber, Thomas Fuchs, Ute Lepp, Bodo Niggemann, Stephan Erdmann, M Raithel, Jorg Kleinetebbe, Joachim SalogaAbstract:Summary Skin testing has a central role in the diagnosis of food allergy. Prick testing is well- established as a routine diagnostic tool. Nonetheless, unstable allergens and the lack of standardized extracts create difficulties in the identification of sensitization to foods in patients with suspected food allergy. Therefore prick-to-prick tests with native (raw, fresh) foods are still recommended. The indications and contraindications are the same as those of routine skin testing in clinical Allergology. We recommend a careful and restricted application of skin tests in patients with a history of severe anaphylaxis to foods.