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Allergy Advisor Digest - May 2012
Editor: Dr. Harris A. Steinman

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This is a monthly digest of interesting information that is being added to Allergy Advisor. While we add a great deal of information every month, here we highlight some of the more interesting articles.
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Microarray based IgE detection in poly-sensitized allergic patients with suspected food allergy - an approach in four clinical cases.

Ragweed pollen collected along high-traffic roads shows a higher allergenicity than pollen sampled in vegetated areas.

Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose.

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.

Changes in major peanut allergens under different pH conditions.

A case of Korean ginseng-induced anaphylaxis confirmed by open oral challenge and basophil activation test.

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis.

Galactose-alpha-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.

Clinical thresholds to egg, hazelnut, milk and peanut: results from a single-center study using standardized challenges.

The natural history of persistent peanut allergy.

Senna-containing laxative inducing blistering dermatitis in toddlers.

Diagnostic approach to drug allergy.

A comprehensive review of legume allergy.

Non-IgE-mediated gastrointestinal food allergies: distinct differences in clinical phenotype between western countries and Japan.

Sesame seed food allergy.

Hidden allergens in foods and implications for labelling and clinical care of food allergic patients.

The added value of allergen microarray technique to the management of poly-sensitized allergic patients.

Contact allergy to dimethacrylate.

Eosinophilic gastroenteritis due to cow's milk allergy presenting with acute pancreatitis.

Sensitization to common ragweed in Southern Bavaria: clinical and geographical risk factors in atopic patients.

Paracetamol hypersensitivity: clinical features, mechanism and role of specific IgE.

Food protein-induced enterocolitis syndrome in an exclusively breast-fed infant-an uncommon entity.

Clinical relevance of IgE to recombinant Gly m 4 in the diagnosis of adult soybean allergy.

Multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness.

Over- and underestimated parameters in severe Hymenoptera venom-induced anaphylaxis: Cardiovascular medication and absence of urticaria/angioedema.

Spectrum of gluten-related disorders: consensus on new nomenclature and classification.

Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica.

Fish and shellfish allergy in children: Review of a persistent food allergy.

Peanut sensitization during the first 5 yr of life is associated with elevated levels of peanut-specific IgG.

Microarray based IgE detection in poly-sensitized allergic patients with suspected food allergy - an approach in four clinical cases.
This article describes the clinical usefulness of a microarray-based IgE detection assay (ISAC(®)) with skin tests and specific IgE with standard allergens (sIgE) or their monocomponents in four case reports of patients poly-sensitized to aeroallergens and food.

Case 1: a woman with rhinitis, oral allergy syndrome to several fruits and anaphylaxis to cherry. Diagnostic tests supported non-specific lipid transfer proteins (nsLTPs) primary sensitization.

Case 2: a woman with exercise-induced asthma, rhino-conjunctivitis and oral allergy syndrome to fresh fruits of different families. A diagnosis of primary grass and weed pollen allergy with profilin and pathogenesis-related protein family 10 (PR-10) cross-reactive food allergy was proposed.

Case 3: a man with atopic eczema, asthma, rhinitis, and multiple anaphylactic episodes with cashew nuts and oral allergy syndrome to fruits. The diagnostic workup supported a primary birch pollen allergy with PR-10 and nsLTPs cross-reactive food allergy.

Case 4: a woman with rhino-conjunctivitis, per-operative anaphylaxis due to latex and recent pharyngeal angio-oedema episodes. The diagnosis was a primary grass and weed pollen allergy with equivocal profilin sensitization and no obvious cross-reactivity mediated by nsLTPs sensitization.

The complete article can be read here: http://alturl.com/ajvve

Microarray based IgE detection in poly-sensitized allergic patients with suspected food allergy - an approach in four clinical cases.
Vieira T, Lopes C, Pereira AM, Araujo L, Moreira A, Delgado L.
Allergol Immunopathol (Madr) 2012 May;40(3):172-180

Ragweed pollen collected along high-traffic roads shows a higher allergenicity than pollen sampled in vegetated areas.
Mature pollen grains were collected from ragweed plants grown along main roadsides and in vegetated areas of Po river plain. The percentage of sub-pollen particle-releasing grains (SPPGs) was evaluated immediately after sampling by microscope and image analysis. Immunochemistry and LC-MS/MS were applied to assess the whole allergenicity and the allergen pattern characterizing the different pollen samples. No statistical difference was detected in the percentage of SPPGs among pollen samples. Specifically, after hydration, the mean percentage was very low (<4%) in all the samples, regardless of the site of origin. On the contrary, pollen collected along high-traffic roads showed a higher whole allergenicity than pollen from low-traffic roads and vegetated areas which showed a reactivity similar to that of the commercial pollen 'Allergon', used as a standard. The detected higher allergenicity levels were attributed to both quantitative and qualitative differences in allergen pattern.

Ragweed pollen collected along high-traffic roads shows a higher allergenicity than pollen sampled in vegetated areas.
Ghiani A, Aina R, Asero R, Bellotto E, Citterio S.
Allergy 2012 May 14;

Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose.
The aim of this study was to explore whether anaphylaxis to mammalian kidney is also associated with galactose-alpha-1,3-galactose (alphaGal)-specific IgE. Fourteen patients with anaphylaxis to pork or beef kidney underwent prick tests to meat and kidney. Some patients also underwent skin tests to Erbitux(®) (cetuximab). IgE antibodies to alphaGal, swine urine proteins, beef and pork meat, serum albumin proteins, cat, and rFel d 1 were measured by ImmunoCAP(®). The alphaGal levels were estimated in meats and kidney by ELISA inhibition assay. Cross-reactivity between alphaGal and pork kidney was studied with the ImmunoCAP(®) inhibition assay.

Among the 14 patients, 12 presented with anaphylactic shock. Reactions occurred within 2 h from exposure in 67% of patients. Associated risk factors were observed in 10 cases, and alcohol was the main cofactor. Three patients underwent an oral challenge to pork kidney, and anaphylaxis occurred after ingestion of small quantities (1-2 g). Prick tests to kidney were positive in 54% of patients. All tested patients showed positive skin tests to Erbitux(®). All patients tested positive for IgE to alphaGal, with levels ranging from 0.4 to 294 kU/l. IgE binding to alphaGal was inhibited by raw pork kidney extract (mean, 77%; range, 55-87%), which showed a high amount of alphaGal determinants.

Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose.
Morisset M, Richard C, Astier C, Jacquenet S, Croizier A, Beaudouin E, Cordebar V, Morel-Codreanu F, Petit N, Moneret-Vautrin DA, Kanny G.
Allergy 2012 May;67(5):699-704

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.
Previous studies suggest that children with egg allergy may be able to tolerate baked egg. Reliable predictors of a successful baked egg challenge are not well established. This study examined egg white-specific IgE levels, skin-prick test (SPT) results, and age as predictors of baked egg oral food challenge (OFC) outcomes, using a retrospective chart review of children, aged 2-18 years, receiving an egg white-specific IgE level, SPT, and OFC to baked egg from 2008 to 2010. Fifty-two oral baked egg challenges were conducted. Of the 52 challenges, 83% (n = 43) passed and 17% (n = 9) failed, including 2 having anaphylaxis. Median SPT wheal size was 12 mm (range, 0-35 mm) for passed challenges and 17 mm (range, 10-30 mm) for failed challenges (p = 0.091). The negative predictive value for passing the OFC was 100% (9 of 9) if SPT wheal size was <10 mm. Median egg white-specific IgE was 2.02 kU/L (range, <0.35-13.00 kU/L) for passed challenges and 1.52 kU/L (range, 0.51-6.10 kU/L) for failed challenges (p = 0.660). Receiver operating characteristic (ROC) curve analysis for SPT revealed an area under the curve (AUC) of 0.64. ROC curve analysis for egg white-specific IgE revealed an AUC of 0.63. There was no significant difference in age between patients who failed and those who passed (median = 8.8 years versus 7.0 years; p = 0.721). Based on our sample, SPT, egg white-specific IgE and age are not good predictors of passing a baked egg challenge. However, there was a trend for more predictability with SPT wheal size

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.
Cortot CF, Sheehan WJ, Permaul P, Baxi SN, Gaffin JM, Dioun AF, Hoffman EB, Schneider LC, Phipatanakul W.
Allergy Asthma Proc 2012 May;33(3):275-281

Changes in major peanut allergens under different pH conditions.
This study evaluated the effects of various pH conditions on major peanut allergens. The density of Ara h 1 was reduced by treatment with pH 1.0, 3.0, or 5.0 acetic acid, or commercial vinegar. Ara h 2 remained largely unchanged after treatment with pH 5.0 acetic acid, and was decreased following treatment with pH 1.0, 2.3, or 3.0 acetic acid. Ara h 3 and Ara h 6 appeared as a thick band after treatment with pH 1.0 acetic acid and commercial vinegar. IgE-binding intensities to Ara h 1, Ara h 2, and Ara h 3 were significantly reduced after treatment with pH 1.0 acetic acid or commercial vinegar. These data suggest that treatment with acetic acid at various pH values affects peanut allergenicity and may explain the low prevalence of peanut allergy in Korea.

Changes in major peanut allergens under different pH conditions.
Kim J, Lee J, Seo WH, Han Y, Ahn K, Lee SI.
Allergy Asthma Immunol Res 2012 May;4(3):157-160

A case of Korean ginseng-induced anaphylaxis confirmed by open oral challenge and basophil activation test.
Two case reports of Korean ginseng-induced allergic reactions have been published; both were inhalation-induced respiratory allergies in occupational settings. In this report, the authors discuss the first case of anaphylaxis that developed after an oral intake of ginseng, confirmed by an open oral challenge, a skin prick test (SPT), and a basophil activation test (BAT). A 44-year-old man experienced rhinorrhea and nasal stiffness, followed by respiratory difficulty with wheeze and abdominal pain 10 minutes after oral intake of fresh ginseng. Total serum IgE level was 41 IU/mL. The SPT results showed strong positive responses to alder, birch pollens, and ginseng extracts. An open oral challenge with 50 g of fresh ginseng resulted in an immediate onset of facial flushing, cough, respiratory difficulty with wheeze, and abdominal pain combined with a significant decrease in FEV1 levels (54% from the baseline). Serum-specific IgE and IgG4 antibodies were not detectable. BAT showed increase in the expression of CD203c and CD63 with the addition of ginseng extract in a dose-dependent manner. Therefore ooral intake of Korean ginseng could induce anaphylaxis, which is mediated by non-IgE-dependent direct activation of basophil/mast cells.

A case of Korean ginseng-induced anaphylaxis confirmed by open oral challenge and basophil activation test.
Lee JY, Jin HJ, Park JW, Jung SK, Jang JY, Park HS.
Allergy Asthma Immunol Res 2012 Mar;4(2):110-111

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis.
This study evaluated the predictive value of a negative SPT with extensively heated (EH) milk or egg in determining whether a child would tolerate an OFC to the EH food product. Fifty-eight patients had negative SPTs to the EH milk or egg in a muffin and underwent OFC to the appropriate EH food in the outpatient clinic. Fifty-five of these patients tolerated the OFC. The negative predictive value for the SPT with the EH food product was 94.8%. SPT with EH milk or egg products was predictive of a successful OFC to the same food. Larger prospective studies are required to substantiate these findings.

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis.
Faraj Z, Kim HL.
Allergy Asthma Clin Immunol 2012 May 16;8(1):5

Galactose-alpha-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.
IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose (alpha-gal) are common in the southeastern United States. These antibodies, which are induced by ectoparasitic ticks, can give rise to positive skin tests or serum assays with cat extract. This study evaluated the relationship between IgE antibodies to alpha-gal and asthma, and compared this with the relationship between asthma and IgE antibodies to Fel d 1 and other protein allergens. Patients being investigated for recurrent anaphylaxis, angioedema, or acute urticaria were evaluated. Results were compared with control subjects and cohorts from the emergency department in Virginia (n = 130), northern Sweden (n = 963), and rural Kenya (n = 131). Patients in Virginia with high-titer IgE antibodies to alpha-gal had normal lung function, low levels of exhaled nitric oxide, and low prevalence of asthma symptoms. Among patients in the emergency department and children in Kenya, there was no association between IgE antibodies to alpha-gal and asthma (odds ratios, 1.04 and 0.75, respectively). In Sweden, IgE antibodies to cat were closely correlated with IgE antibodies to Fel d 1 and to asthma.

Galactose-alpha-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.
Commins SP, Kelly LA, Ronmark E, James HR, Pochan SL, Peters EJ, Lundback B, Nganga LW, Cooper PJ, Hoskins JM, Eapen SS, Matos LA, McBride DC, Heymann PW, Woodfolk JA, Perzanowski MS, Platts-.
Am J Respir Crit Care Med 2012 Apr 1;185(7):723-730

Clinical thresholds to egg, hazelnut, milk and peanut: results from a single-center study using standardized challenges.
The objective of this study was to establish and compare clinical threshold values for egg, hazelnut, milk and peanut, and correlating them to severity of symptoms. Seven hundred eighty-one challenges were performed in 487 patients (age range, 0.5-73.5 years). Using interval censoring survival analysis, the dose distribution of thresholds was fitted to a log-normal function. Symptom score was correlated to thresholds. Based on the 405 challenges resulting in objective signs, similar distribution of thresholds for hazelnut, milk, and peanut challenges were found, whereas individuals with egg allergy were bimodally distributed with a high or a low threshold. Eliciting dose in 10% (95% confidence interval) was 42.9 (24-76.8) mg whole eggs, 133.8 (95.9-186.6) mg whole hazelnut, 106.5 (59.7-190.6) mg roasted peanut, and 2.9 (1.5-5.4) mL milk. Adults showed more severe symptoms and signs than children, and peanut caused more severe reactions than the 3 other foods. Thresholds for the different foods were not comparable, and eliciting dose for the 4 foods differed, even if adjusted for protein content. Increasing age but not a low threshold dose is associated with severe symptoms on challenge.

Clinical thresholds to egg, hazelnut, milk and peanut: results from a single-center study using standardized challenges.
Eller E, Hansen TK, Bindslev-Jensen C.
Ann Allergy Asthma Immunol 2012 May;108(5):332-336

The natural history of persistent peanut allergy.
The primary outcome of this study was the frequency of inadvertent peanut exposure. Secondary outcomes included clinical characteristics, trends in P-IgE, characteristics of accidental exposures, and predictors of reaction severity in patients with persistent peanut allergy. Seven hundred eighty-two patients were studied, 524 of them male. The median age at initial observation was 1.4 years; the median duration of follow-up was 5.3 years. Of the 782 patients, 93.1% were avoiding other foods, 70.8% had atopic dermatitis, 57.3% allergic rhinitis, and 55.8% asthma. The median initial P-IgE was 28.0 kU/L, and the median peak P-IgE was 68.1. Six hundred eighty-five exposures were seen among 455 patients: 75.9% ingestion, 13.6% contact, 4.5% airborne. 73.7% resulted in urticaria/angioedema, 22.2% lower respiratory symptoms, 21.2% gastrointestinal symptoms, and 7.7% oral erythema/pruritus. Treatment included antihistamines (33.4%), emergency department visits (16.5%), epinephrine (13.1%), corticosteroids (7.7%), albuterol (3.2%), no treatment (26.3%), and not recorded (29.6%). The rate of postdiagnosis ingestion was 4.7%/year; exposures with severe reactions, 1.6%/year; reactions treated with epinephrine, 1.1%/year. Reaction severity did not change with repeated exposure. Severe reactions were associated with higher P-IgE, but not with age, sex, or asthma.

The natural history of persistent peanut allergy.
Neuman-Sunshine DL, Eckman JA, Keet CA, Matsui EC, Peng RD, Lenehan PJ, Wood RA.
Ann Allergy Asthma Immunol 2012 May;108(5):326-331

Senna-containing laxative inducing blistering dermatitis in toddlers.
A 14-month old boy was evaluated for a diaper rash of 4 months' duration. He had received 2.125 mL/d of oral senna (Little Tummys; Little Remedies) leading to frequent stools. Following onset of treatment, the patient returned with sudden worsening of the eruption after waking up with a large loose stool in his diaper. He was found to have a well-demarcated, diamond-shaped erosion with desquamation involving the lower scrotum, perineum, and buttocks. A senna laxative induced dermatitis was diagnosed, and treatment with the laxative was discontinued. Very soon thereafter, the eruption resolved completely.

Case 2

A 3-year-old boy presented with a well-demarcated diamond-shaped erosion with bullae. The family reported ingestion of several chocolate squares of ex-lax (Novartis), which he mistook for candy 1 night prior to admission. He was wearing diapers at night, which led to overnight contact of his skin with senna-induced diarrhea.

Senna-containing laxative inducing blistering dermatitis in toddlers.
Smith WA, Taintor AR, Kos L, Drolet B.
Arch Dermatol 2012 Mar;148(3):402-404

Diagnostic approach to drug allergy.
The approach to drug hypersensitivity always comprises a clinical and a diagnostic workup. About 15% of drug side effects are due to hypersensitivity reactions. All types of immunological reactions can be induced by drugs, but type I and type IV reactions are seen most often. The initial judgment of the skin symptoms is therefore one of the key factors besides a stringent history of drug intake for a further diagnostic workup. The goal of a diagnostic workup is not only to identify the culprit drug, but also to defer the patient from similar drugs in order to prevent a second episode. In the case of missing alternatives and unidentified drug sensitivity, reexposure to the previous drug must be discussed; however, in severe cutaneous reactions this should generally be avoided

Diagnostic approach to drug allergy.
Harr T.
Chem Immunol Allergy 2012;9747-60

A comprehensive review of legume allergy.
Legumes belonging to Fabaceae family of the order Fabales are a rich and important source of proteins and many essential elements. Due to its nutritious elements, these are preferably included in human diet in most part of the world. But, unfortunately, IgE binding proteins have been identified in majority of legumes, and allergenic response to these legumes may range from mild skin reactions to life-threatening anaphylactic reaction. Overall, allergenicity due to consumption of legumes in decreasing order may be peanut, soybean, lentil, chickpea, pea, mung bean, and red gram. So far, several allergens from different legumes have been identified and characterized. Most of identified allergens belong to storage proteins family, profilins, or the pathogenesis-related proteins. Legumes also have property of immunological cross-reactivity among themselves and from other sources that also increases the severity of allergenic response to a particular legume. This review summarizes the currently available knowledge on legume allergy and describes the allergenic problems associated with different legumes. It also tries to explore about the legume allergens identified so far by different scientific groups. The culmination of knowledge about identification and characterization of allergens from different legumes will be helpful in diagnosis and treatment of allergy, for development of novel therapeutic strategies, for strict avoidance of particular legume in diet by susceptible individual and also to produce hypoallergenic cultivars of leguminous crop through conventional breeding or genetic modification

A comprehensive review of legume allergy.
Verma AK, Kumar S, Das M, Dwivedi PD.
Clin Rev Allergy Immunol 2012 May 4;

Non-IgE-mediated gastrointestinal food allergies: distinct differences in clinical phenotype between western countries and Japan.
"Non-IgE-mediated gastrointestinal food allergies, including food-protein-induced enterocolitis, enteropathy, proctocolitis and allergic eosinophilic gastroenteritis, seem to be increasing in several regions in the world. However, unlike the case of IgE-mediated food allergy, development of diagnostic laboratory tests and our understanding of the immunological mechanisms involved in non-IgE-mediated gastrointestinal food allergies lag. Although the clinical entities in Western countries have been well established, the clinical phenotypes might differ somewhat among the human races and geographical regions. In Japan, non-IgE-mediated gastrointestinal food allergies have increased sharply since the late 1990s, and clinicians have sometimes experienced confusion because of differences in the clinical phenotypes from those seen in Western countries. Aiming to solve this problem, we performed clinical research and determined a useful method for dividing patients into four clusters with distinctive clinical symptoms. We are confident this method will help in diagnosing and treating these patients. We also tried to clarify the differences between these patients in Japan and Western countries."

Non-IgE-mediated gastrointestinal food allergies: distinct differences in clinical phenotype between western countries and Japan.
Nomura I, Morita H, Ohya Y, Saito H, Matsumoto K.
Curr Allergy Asthma Rep 2012 May 27;

Sesame seed food allergy.
The number of reports regarding sesame seed food allergy (SFA) has increased significantly worldwide over the past two decades, either due to a genuine increase in SFA or merely an increase in its awareness. Based on the available data, SFA is estimated to affect 0.1-0.2 % of the population, in areas where the food is available. Albeit this prevalence appears to be relatively low, it is approximately one-half of that of persistent cow's milk allergy. The significant number of SFA patients presenting as anaphylaxis indicates the potential risk. Many reports based the diagnosis of SFA on sensitization criteria alone, particularly amongst atopic dermatitis patients. Elimination of sesame from the diet of these children utilizing such criteria is not justified, and may even increase the risk for developing SFA.

Sesame seed food allergy.
Dalal I, Goldberg M, Katz Y.
Curr Allergy Asthma Rep 2012 May 19;

Hidden allergens in foods and implications for labelling and clinical care of food allergic patients.
This paper will review the current literature that is available regarding: consumer behaviour and attitudes regarding precautionary labelling; risk to the consumer and analytical results of products that bear advisory labelling; the current debate regarding whether a tolerable level of risk can be obtained in food allergy; and finally, the newly introduced Voluntary Incidental Trace Allergen Labelling (VITAL) system operating in Australia.

Hidden allergens in foods and implications for labelling and clinical care of food allergic patients.
Zurzolo GA, Mathai ML, Koplin JJ, Allen KJ.
Curr Allergy Asthma Rep 2012 May 4;

The added value of allergen microarray technique to the management of poly-sensitized allergic patients.
This review evaluates the relevance of results obtained using allergen microarray technique for the description of the IgE repertoire in allergic patients. The availability of highly purified or recombinant allergen components has deeply modified the laboratory approach to allergy diagnosis that, now, it cannot be limited to the detection of IgE specific to extractive allergens. These contain both specific components (i.e. molecules strictly associated to that allergen source) and pan-allergen or cross-reacting allergens (i.e. molecules that are present in different similar allergen sources or that are present in highly homologous structures in different species). Newer techniques such as recombinant allergen testing and allergen microarray allow a more detailed evaluation of IgE responses. Future research is needed to more clearly define their role in clinical practice.

The added value of allergen microarray technique to the management of poly-sensitized allergic patients.
Melioli G, Compalati E, Bonini S, Canonica GW.
Curr Opin Allergy Clin Immunol 2012 May 22;

Contact allergy to dimethacrylate.
A 55-year-old woman with a 10-year history of persistent pruritus and burning sensation of the gums every time she wore her dentures. Initially she developed swelling and erythema of the face soon after the dentures were placed on the gums. These symptoms abated after a barrier liner was applied between her gums and the dentures. However, the burning sensation and pruritus of the gums progressively worsened and she started to develop blisters on the gums. The skin allergen patch test was 3+ positive with erythema, edema, papules, ulceration, and pruritus for the denture component dimethacrylate. The diagnosis was supported by the patient's medical history, notably positive patch test, and complete amelioration of the symptoms upon cessation of dimethacrylate denture usage.

Contact allergy to dimethacrylate.
Vaswani R, Kim SJ, Sanchez A, Vaswani S.
Cutis 2012 Jan;89(1):10-12

Eosinophilic gastroenteritis due to cow's milk allergy presenting with acute pancreatitis.
Eosinophilic gastroenteritis (EGE) is characterized by eosinophilic infiltration of the digestive organs, most commonly of the stomach and the duodenum. Symptoms of EGE are nonspecific and include nausea, vomiting, abdominal pain, dyspepsia, malabsorption, ascites and weight loss. The various symptoms of EGE depend on its location and the depth of gastrointestinal eosinophil infiltration. A patient presenting with acute pancreatitis caused by a milk allergy is reported. The patient's symptoms rapidly improved after treatment with corticosteroids, and he remained symptom-free for more than 20 months by the elimination of cow's milk from his diet. Serum titers of pancreatic enzymes and total bilirubin simultaneously recovered and blood eosinophil counts normalized.

Eosinophilic gastroenteritis due to cow's milk allergy presenting with acute pancreatitis.
Suzuki S, Homma T, Kurokawa M, Matsukura S, Adachi M, Wakabayashi K, Nozu F, Tazaki T, Kimura T, Matsuura T, Fukuda M, Shiozawa E, Takimoto M.
Int Arch Allergy Immunol 2012;158 Suppl 175-82

Sensitization to common ragweed in Southern Bavaria: clinical and geographical risk factors in atopic patients.
The aim of this study was to evaluate the association of a variety of clinical, geographical and demographical variables with common ragweed (Ambrosia artemisiifolia) sensitization and also to determine its frequency in southern Bavaria. 977 patients with a documented or suspected atopic disease or food allergy was enrolled. According to skin prick tests, 190 patients (19.5%) were sensitized to ragweed. The frequency of this finding increased significantly with a rising number of additional sensitizations. Other less important predictors for a ragweed sensitization were male gender, mugwort sensitization, food allergy and a maximum of complaints in September or October. County of residence, extent of local ragweed cover or type of residential area were without relevance. Of 48 sensitized patients, 26 (54.2%) had a positive conjunctival provocation test.

Sensitization to common ragweed in Southern Bavaria: clinical and geographical risk factors in atopic patients.
Rueff F, Przybilla B, Walker A, Gmeiner J, Kramer M, Sabanes-Bove D, Kuchenhoff H, Herzinger T.
Int Arch Allergy Immunol 2012 May 4;159(1):65-74

Paracetamol hypersensitivity: clinical features, mechanism and role of specific IgE.
Hypersensitivity reactions to paracetamol appear to be increasing, but there are few prevalence data. The authors identified the clinical features of 32 patients with suspected paracetamol allergy, investigated the underlying mechanism and examined co-existing non-steroidal anti-inflammatory drug (NSAID) tolerance. Methods: A clinical history was taken and skin tests and an oral challenge were performed in 32 patients with suspected paracetamol allergy. Patients presented with a combination of urticaria, angio-oedema (face, hands), erythema (cutaneous features in 94%), dyspnoea (including laryngeal oedema), rhinoconjunctivitis, cough, abdominal pain and anaphylaxis. Two patients had a positive skin prick test (SPT) and unequivocal history of acute urticaria/facial angio-oedema/conjunctivitis/cough after paracetamol with no other triggers. One patient had a positive intradermal test. Oral challenge was positive in 15 of 31 patients (including self-challenge in 4), triggering (a combination of) rhinitis, conjunctivitis, pruritus, erythema, urticaria, angio-oedema, dyspnoea and abdominal pain. Sensitivity was evident in 1 patient on the basis of the patient's history. Overall, paracetamol hypersensitivity was confirmed in 16 of the 32 patients (50%). Twelve of the 16 paracetamol-allergic patients (75%) tolerated NSAIDs (negative challenge in 6, negative history in 6). Four of these 16 patients (25%) were intolerant of NSAIDs (positive challenge in 1, self-challenge in 3).

Paracetamol hypersensitivity: clinical features, mechanism and role of specific IgE.
Rutkowski K, Nasser SM, Ewan PW.
Int Arch Allergy Immunol 2012 May 3;159(1):60-64

Food protein-induced enterocolitis syndrome in an exclusively breast-fed infant-an uncommon entity.
A case of acute soy FPIES in an exclusively breast- fed infant. At age 5 months, the infant received his first bottle of soy formula. Two hours later, he developed profuse vomiting, pallor, and diarrhea. Two weeks later, after drinking soy formula again, he developed profuse vomiting and pallor 2 hours later. At age 6 months, the infant remained exclusively breast-fed. One evening, the infants mother consumed a large serving of soy ice cream for the first time, having previously consumed soy only in processed foods. The child was not breast-fed overnight. Twelve hours later, the mother breast-fed the infant, and 3 hours after the feed, the infant developed profuse vomiting, pallor, and cyanosis and became floppy. Skin prick to soy was negative (0 mm), and a diagnosis of soy FPIES was made.This case did not have clinical features consistent with chronic FPIES despite the mother continuing to ingest soy in processed foods.

Soy isoflavones are soy proteins found in high concentration in soy foods and are reliable biomarkers of human soy consumption. Excretion of isoflavones into breast milk occurs in a dose-dependent manner, and peak concentrations occur 10 to 14 hours after soy ingestion. The authors speculate that this case had FPIES after a breast-feeding since the mother ingested a large quantity of soy and soy excretion in breast milk was at a time when peak concentrations are reported to occur.

Food protein-induced enterocolitis syndrome in an exclusively breast-fed infant-an uncommon entity.
Tan J, Campbell D, Mehr S.
J Allergy Clin Immunol 2012 Jan 30;

Clinical relevance of IgE to recombinant Gly m 4 in the diagnosis of adult soybean allergy.
The clinical relevance of measuring Gly m 4 is still debated, considering that the concentration of Gly m 4 in soybean extract is quite low and many patients allergic to birch pollen have IgE to Gly m 4 without reporting any symptoms to soybean. Sensitization to the soybean storage proteins Gly m 5 and Gly m 6 have been shown to contribute to more severe soy- bean allergy. This study evaluated 21 consecutive adult Japanese patients with soybean allergy. The most frequent symptom among the soybean-allergic patients was oral allergy syndrome (17 of 21) followed by cough/dyspnea (10 of 21) and abdominal pain/diarrhea (8 of 21). Soymilk was the most provoking allergen in relation to exposure. Fifteen (71%) of the 21 patients reported reaction to any of the moderately heated soy products such as tofu and boiled edamame, and none to the fermented soy products such as natto, miso, and soy sauce. Soybean allergy was diagnosed on the basis of a convincing case history and results of positive skin prick test to soybean extract and/or soymilk. IgE levels to alder pollen, birch pollen, soybean extracts, recombinant Bet v 1 (rBet v 1), rGly m 4, nGly m 5, and nGly m 6 were measured.

The frequency of sensitization to soybean in soybean-allergic patients was relatively low (48%), whereas all the soybean-allergic patients were sensitized to rGly m 4. Only one patient was sensitized to the soybean storage proteins nGly m 5 and nGly m 6. IgE levels to rGly m 4, as well as to alder pollen, birch pollen, and rBet v 1, were significantly higher in the soybean- allergic group than in the control group (rGly m 4, 15.0 vs 0.68 kUA/L; alder, 48.4 vs 4.77; birch, 42.4 vs 6.49; rBet v 1, 48.4 vs 3.85 kUA/L. This study demonstrates the characteristics of adult soybean allergy and the impact of sensitization to Gly m 4 in a Japanese population. In Japan, alder pollen (alder is part of the Betulaceae family) is of minor clinical importance in terms of respiratory sensitization, compared with Japanese cedar pollen. All the patients were sensitized to alder pollen and rGly m 4. IgE levels to rGly m 4 were markedly higher in the soybean-allergic patients than in the alder-pollensensitized control patients. These findings highlight the clinical impact of respiratory sensitization to pollen-derived pathogenesis-related class 10 protein on the development of adult soybean allergy.

Clinical relevance of IgE to recombinant Gly m 4 in the diagnosis of adult soybean allergy.
Fukutomi Y, Sjolander S, Nakazawa T, Borres MP, Ishii T, Nakayama S, Tanaka A, Taniguchi M, Saito A, Yasueda H, Nakamura H, Akiyama K.
J Allergy Clin Immunol 2012 Jan 27;

Multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness.
The aim of this study was to investigate the IgE antibody profile for a broad spectrum of allergen molecules in asthmatic patients. Participants from the European Community Respiratory Health Survey II (n = 467) were tested with ImmunoCAP ISAC against 103 allergen molecules. Bronchial hyperresponsiveness was measured with a methacholine challenge test and bronchial inflammation with fraction of exhaled nitric oxide (Feno). 38% of the controls and 72% of the asthmatic patients were sensitized against at least 1 of the allergen components. Asthma was independently related to having IgE antibodies against pollen and perennial airway allergens. Increased Feno was independently related to having IgE antibodies against food allergens and perennial allergens, while bronchial responsiveness was independently associated with having IgE antibodies against only perennial allergens. Sensitization to food allergens was related to asthma and increased Feno if IgE antibody against pollen allergens was present. Simultaneous sensitization to perennial, pollen, and food allergens involves the highest risk of asthma (odds ratio = 18.3), bronchial inflammation, and responsiveness.

Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness.
Patelis A, Gunnbjornsdottir M, Malinovschi A, Matsson P, Onell A, Hogman M, Alving K, Janson C.
J Allergy Clin Immunol 2012 May 25;

Over- and underestimated parameters in severe Hymenoptera venom-induced anaphylaxis: Cardiovascular medication and absence of urticaria/angioedema.
The aim of this study was to evaluate indicators and risk factors for severe anaphylaxis due to Hymenoptera field stings with an emphasis on details related to the sting reaction and concurrent medication. 657 consecutive patients fulfilling the criteria for venom immunotherapy. Four significant indicators and risk factors of severe anaphylaxis were identified (P < .001): (1) elevation of baseline serum tryptase (BST), (2) absence of urticaria or angioedema during anaphylaxis, (3) time interval of less than 5 minutes from sting to onset of symptoms, and (4) senior age. The absence of urticaria/angioedema is significantly related to BST elevation (P = .02). No relationship could be established between the severity of anaphylaxis and comorbidities or concurrent cardiovascular medication.

Over- and underestimated parameters in severe Hymenoptera venom-induced anaphylaxis: Cardiovascular medication and absence of urticaria/angioedema.
Stoevesandt J, Hain J, Kerstan A, Trautmann A.
J Allergy Clin Immunol 2012 May 1;

Spectrum of gluten-related disorders: consensus on new nomenclature and classification.
A decade ago celiac disease was considered extremely rare outside Europe and, therefore, was almost completely ignored by health care professionals. In only 10 years, key milestones have moved celiac disease from obscurity into the popular spotlight worldwide. Now we are observing another interesting phenomenon that is generating great confusion among health care professionals. The number of individuals embracing a gluten-free diet (GFD) appears much higher than the projected number of celiac disease patients, fueling a global market of gluten-free products approaching $2.5 billion (US) in global sales in 2010. This trend is supported by the notion that, along with celiac disease, other conditions related to the ingestion of gluten have emerged as health care concerns. This review will summarize our current knowledge about the three main forms of gluten reactions: allergic (wheat allergy), autoimmune (celiac disease, dermatitis herpetiformis and gluten ataxia) and possibly immune-mediated (gluten sensitivity), and also outline pathogenic, clinical and epidemiological differences and propose new nomenclature and classifications.

Spectrum of gluten-related disorders: consensus on new nomenclature and classification.
Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A.
Miscellaneous BMC Med 2012 Feb 7;10:13.

Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica.
This study evaluated bagasse (sugar cane fibres) and microbiological exposure among sugar cane refinery workers in Costa Rica and its relationships with respiratory, allergy and eye problems. During the harvesting season, dust levels were relatively high in some departments, while endotoxin and mould levels were around background levels. Workers' ventilatory lung function differed between departments before, but not during the harvesting season or between seasons. During the harvesting season, the prevalence of wheeze and eye problems almost doubled in workers exposed to bagasse and other types of dust, whereas shortness of breath and rhinitis increased only in bagasse-exposed workers. Reporting wheeze and shortness of breath was positively associated with the number of years working at the refinery, suggesting a long-term health effect. The differences in workers' ventilatory lung function before the harvesting season are unlikely to be explained by bagasse exposure. However, the increase in reported symptoms (wheeze, shortness of breath, eye problems and rhinitis) over the season is likely due to irritation by dust, in particular bagasse, rather than microbiological agents.

Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica.
Gascon M, Kromhout H, Heederik D, Eduard W, van Wendel de JB.
Occup Environ Med 2012 May;69(5):331-338

Fish and shellfish allergy in children: Review of a persistent food allergy.
This review discusses interesting and new findings in the area of fish and shellfish allergy. New allergens and important potential cross-reacting allergens have been identified within the fish family and between shellfish, arachnids, and insects. The diagnostic approach may require prick to-prick tests using crude extracts of both raw and cooked forms of seafood for screening seafood sensitization before a food challenge or where food challenge is not feasible. Allergen-specific immunotherapy can be important; mutated less allergenic seafood proteins have been developed for this purpose. The persistence of allergy because of seafood proteins' resistance after rigorous treatment like cooking and extreme pH is well documented. Additionally, IgE antibodies from individuals with persistent allergy may be directed against different epitopes than those in patients with transient allergy. For a topic as important as this one, new areas of technological developments will likely have a significant impact, to provide more accurate methods of diagnosing useful information to patients about the likely course of their seafood allergy over the course of their childhood and beyond

Fish and shellfish allergy in children: Review of a persistent food allergy.
Tsabouri S, Triga M, Makris M, Kalogeromitros D, Church MK, Priftis KN.
Pediatr Allergy Immunol 2012 May 3;

Peanut sensitization during the first 5 yr of life is associated with elevated levels of peanut-specific IgG.
Peanut-specific IgG or IgG4 levels were elevated in peanut-sensitized children especially those avoiding peanuts. In this study, IgG and IgG4 do not seem to indicate tolerance or protection from sensitization

Peanut sensitization during the first 5 yr of life is associated with elevated levels of peanut-specific IgG.
Sverremark-Ekstrom E, Hultgren EH, Borres MP, Nilsson C.
Pediatr Allergy Immunol 2012 May;23(3):224-229

Allergen-, Food allergy-, Intolerance-related articles

High-dose intravenous immunoglobulin monotherapy for drug-induced hypersensitivity syndrome.
Kito Y, Ito T, Tokura Y, Hashizume H. Acta Derm Venereol 2012 Jan;92(1):100-101

Allergic nickel dermatitis caused by shaving: case report and assessment of nickel release from an electric shaver.
Thyssen JP, Menne T, Zachariae C. Acta Derm Venereol 2012 Jan;92(1):95-96

Acute anaphylactic reaction after prick-by-prick testing for pine nut in a child.
Tosca MA, Olcese R, Ciprandi G, Rossi GA. Allergol Immunopathol (Madr) 2012 May 2;

Microarray based IgE detection in poly-sensitized allergic patients with suspected food allergy - an approach in four clinical cases.
Vieira T, Lopes C, Pereira AM, Araujo L, Moreira A, Delgado L. Allergol Immunopathol (Madr) 2012 May;40(3):172-180

Aspirin-Intolerant Asthma (AIA) Assessment Using the Urinary Biomarkers, Leukotriene E(4)(LTE(4)) and Prostaglandin D(2)(PGD(2)) Metabolites.
Higashi N, Taniguchi M, Mita H, Yamaguchi H, Ono E, Akiyama K. Allergol Int 2012 May 25;0(0):

Diagnostic evaluation of patients with nonimmediate cutaneous hypersensitivity reactions to iodinated contrast media.
Torres MJ, Gomez F, Dona I, Rosado A, Mayorga C, Garcia I, Blanca-Lopez N, Canto G, Blanca M. Allergy 2012 May 15;

Outcome of oral food challenges in children in relation to symptom-eliciting allergen dose and allergen-specific IgE.
Rolinck-Werninghaus C, Niggemann B, Grabenhenrich L, Wahn U, Beyer K. Allergy 2012 May 14;

Ragweed pollen collected along high-traffic roads shows a higher allergenicity than pollen sampled in vegetated areas.
Ghiani A, Aina R, Asero R, Bellotto E, Citterio S. Allergy 2012 May 14;

Surveillance of contact allergies: methods and results of the Information Network of Departments of Dermatology (IVDK).
Schnuch A, Geier J, Lessmann H, Arnold R, Uter W. Allergy 2012 May 7;

Anaphylaxis to pork kidney is related to IgE antibodies specific for galactose-alpha-1,3-galactose.
Morisset M, Richard C, Astier C, Jacquenet S, Croizier A, Beaudouin E, Cordebar V, Morel-Codreanu F, Petit N, Moneret-Vautrin DA, Kanny G. Allergy 2012 May;67(5):699-704

Role of specific IgE and skin-prick testing in predicting food challenge results to baked egg.
Cortot CF, Sheehan WJ, Permaul P, Baxi SN, Gaffin JM, Dioun AF, Hoffman EB, Schneider LC, Phipatanakul W. Allergy Asthma Proc 2012 May;33(3):275-281

Changes in major peanut allergens under different pH conditions.
Kim J, Lee J, Seo WH, Han Y, Ahn K, Lee SI. Allergy Asthma Immunol Res 2012 May;4(3):157-160

Flow Cytometry-Assisted Basophil Activation Test as a Safe Diagnostic Tool for Aspirin/NSAID Hypersenstivity.
Kim MS, Cho YJ. Allergy Asthma Immunol Res 2012 May;4(3):137-142

A case of Korean ginseng-induced anaphylaxis confirmed by open oral challenge and basophil activation test.
Lee JY, Jin HJ, Park JW, Jung SK, Jang JY, Park HS. Allergy Asthma Immunol Res 2012 Mar;4(2):110-111

Skin prick testing with extensively heated milk or egg products helps predict the outcome of an oral food challenge: a retrospective analysis.
Faraj Z, Kim HL. Allergy Asthma Clin Immunol 2012 May 16;8(1):5

Galactose-alpha-1,3-galactose-specific IgE is associated with anaphylaxis but not asthma.
Commins SP, Kelly LA, Ronmark E, James HR, Pochan SL, Peters EJ, Lundback B, Nganga LW, Cooper PJ, Hoskins JM, Eapen SS, Matos LA, McBride DC, Heymann PW, Woodfolk JA, Perzanowski MS, Platts-. Am J Respir Crit Care Med 2012 Apr 1;185(7):723-730

Facial angioedema following hyaluronic acid injection. [French]
Stephan F, Maatouk I, Moutran R, Obeid G. Ann Dermatol Venereol 2012 Jan;139(1):63-64

Complications associated with injectable hyaluronic acid. [French]
Pons-Guiraud A. Ann Dermatol Venereol 2012 Jan;139(1):6-8

Can drug-induced rashes constitute epidemics?. [French]
Roujeau JC. Ann Dermatol Venereol 2012 Jan;139(1):3-5

Peroperative anaphylactic shock in children: management and evaluation. [French]
Lucas-Polomeni MM, Rochefort-Morel C, Delaval Y. Ann Fr Anesth Reanim 2012 Jan;31(1):e45-e46

Consequences of smoke inhalation in the 'Epidemiology of Allergic Diseases in Poland' project (ECAP).
Stankiewicz-Choroszucha BL, Wawrzyniak ZM, Lipiec A, Piekarska B, Kapalczynski WJ, Samolinski BK. Ann Agric Environ Med 2011 Dec;18(2):420-428

Selected environmental aspects of the introduction into the polish market of exotic wood species on the example of caviuna (Machaerium scleroxylon Tul.).
Krauss A, Krauss H, Waliszewska B, Piatek J. Ann Agric Environ Med 2011 Dec;18(2):345-349

Clinical thresholds to egg, hazelnut, milk and peanut: results from a single-center study using standardized challenges.
Eller E, Hansen TK, Bindslev-Jensen C. Ann Allergy Asthma Immunol 2012 May;108(5):332-336

The natural history of persistent peanut allergy.
Neuman-Sunshine DL, Eckman JA, Keet CA, Matsui EC, Peng RD, Lenehan PJ, Wood RA. Ann Allergy Asthma Immunol 2012 May;108(5):326-331

Timing the transfer of responsibilities for anaphylaxis recognition and use of an epinephrine auto-injector from adults to children and teenagers: pediatric allergists' perspective.
Simons E, Sicherer SH, Simons FE. Ann Allergy Asthma Immunol 2012 May;108(5):321-325

Allergen of the month-ginkgo.
Weber RW. Ann Allergy Asthma Immunol 2012 May;108(5):A12

Impact of climate change on aeroallergens.
Weber RW. Ann Allergy Asthma Immunol 2012 May;108(5):294-299

Food allergy: diagnosis and beyond.
Assa'ad AH, Bahna SL. Ann Allergy Asthma Immunol 2012 May;108(5):289-290

Senna-containing laxative inducing blistering dermatitis in toddlers.
Smith WA, Taintor AR, Kos L, Drolet B. Arch Dermatol 2012 Mar;148(3):402-404

Isolation of filamentous fungi from sputum in asthma is associated with reduced post-bronchodilator FEV1.
Agbetile J, Fairs A, Desai D, Hargadon B, Bourne M, Mutalithas K, Edwards R, Morley JP, Monteiro WR, Kulkarni NS, Green RH, Pavord ID, Bradding P, Brightling CE, Wardlaw AJ, Pashley CH. Clin Exp Allergy 2012 May;42(5):782-791

Cutaneous drug eruptions associated with the use of biologies and cutaneous drug eruptions mimicking specific skin diseases.
Seneschal J, Milpied B, Taieb A. Chem Immunol Allergy 2012;97203-216

Cutaneous drug eruptions associated with the use of new oncological drugs.
Belloni B, Schonewolf N, Rozati S, Goldinger SM, Dummer R. Chem Immunol Allergy 2012;97191-202

Immediate and delayed cutaneous reactions to radiocontrast media.
Brockow K. Chem Immunol Allergy 2012;97180-190

Phototoxic and photoallergic cutaneous drug reactions.
Glatz M, Hofbauer GF. Chem Immunol Allergy 2012;97167-179

Stevens-Johnson syndrome and toxic epidermal necrolysis.
Harr T, French LE. Chem Immunol Allergy 2012;97149-166

Drug-induced hypersensitivity syndrome: recent advances in the diagnosis, pathogenesis and management.
Shiohara T, Kano Y, Takahashi R, Ishida T, Mizukawa Y. Chem Immunol Allergy 2012;97122-138

Drug-induced angioedema.
Lerch M. Chem Immunol Allergy 2012;9798-105

Uncomplicated drug-induced disseminated exanthemas.
Bircher AJ. Chem Immunol Allergy 2012;9779-97

Histopathological patterns indicative of distinct adverse drug reactions.
Kerl K. Chem Immunol Allergy 2012;9761-78

Diagnostic approach to drug allergy.
Harr T. Chem Immunol Allergy 2012;9747-60

Etiology and pathogenesis of adverse drug reactions.
Hausmann O, Schnyder B, Pichler WJ. Chem Immunol Allergy 2012;9732-46

Genetics and the potential for predictive tests in adverse drug reactions.
Pirmohamed M. Chem Immunol Allergy 2012;9718-31

Epidemiology of cutaneous adverse drug reactions.
Mockenhaupt M. Chem Immunol Allergy 2012;971-17

A comprehensive review of legume allergy.
Verma AK, Kumar S, Das M, Dwivedi PD. Clin Rev Allergy Immunol 2012 May 4;

Role of cockroach proteases in allergic disease.
Page K. Curr Allergy Asthma Rep 2012 May 29;

Non-IgE-mediated gastrointestinal food allergies: distinct differences in clinical phenotype between western countries and Japan.
Nomura I, Morita H, Ohya Y, Saito H, Matsumoto K. Curr Allergy Asthma Rep 2012 May 27;

Does early feeding promote development of oral tolerance?
Palmer DJ, Prescott SL. Curr Allergy Asthma Rep 2012 May 27;

Sesame seed food allergy.
Dalal I, Goldberg M, Katz Y. Curr Allergy Asthma Rep 2012 May 19;

Chinese herbal therapy for the treatment of food allergy.
Wang J, Li XM. Curr Allergy Asthma Rep 2012 May 12;

Addressing food allergy issues within child care centers.
Leo HL, Clark NM. Curr Allergy Asthma Rep 2012 May 8;

Hidden allergens in foods and implications for labelling and clinical care of food allergic patients.
Zurzolo GA, Mathai ML, Koplin JJ, Allen KJ. Curr Allergy Asthma Rep 2012 May 4;

A review on the diagnosis and management of food-induced gastrointestinal allergies.
R Meyer, C Schwarz, N Shah. Current Allergy and Clinical Immunology 2012;25(1):10-17.

Food allergy prevention
K Grimshaw Current Allergy and Clinical Immunology 2012;25(1):18-23.

Food allergy in South Africa: Joining the food allergy epidemic?
C Gray, S Kling Current Allergy and Clinical Immunology 2012;25(1):24-29

Peanut aspiration masquerading as an asthma exacerbation
ME Levin, K Chambers, N Brice Current Allergy and Clinical Immunology 2012;25(1):38-40.

Skin hypersensitivity reactions to preservatives
T Isaacs Current Allergy and Clinical Immunology 2012;25(1):41-46.

The added value of allergen microarray technique to the management of poly-sensitized allergic patients.
Melioli G, Compalati E, Bonini S, Canonica GW. Curr Opin Allergy Clin Immunol 2012 May 22;

Contact allergy to dimethacrylate.
Vaswani R, Kim SJ, Sanchez A, Vaswani S. Cutis 2012 Jan;89(1):10-12

The persistence of allergen exposure favors pulmonary function decline in workers with allergic occupational asthma.
Di GL, Cavallucci E, Braga M, Renzetti A, Schiavone C, Quecchia C, Petrarca C, Di GM. Int Arch Occup Environ Health 2012 Feb;85(2):181-188

Eosinophilic gastrointestinal disorder in an infant with feeding dysfunction.
Yamada Y, Kato M, Toki F, Watanabe M, Nishi A, Matsushita I, Hirato J, Hayashi Y. Int Arch Allergy Immunol 2012;158 Suppl 183-86

Eosinophilic gastroenteritis due to cow's milk allergy presenting with acute pancreatitis.
Suzuki S, Homma T, Kurokawa M, Matsukura S, Adachi M, Wakabayashi K, Nozu F, Tazaki T, Kimura T, Matsuura T, Fukuda M, Shiozawa E, Takimoto M. Int Arch Allergy Immunol 2012;158 Suppl 175-82

Alternaria Fungus Induces the Production of GM-CSF, Interleukin-6 and Interleukin-8 and Calcium Signaling in Human Airway Epithelium through Protease-Activated Receptor 2.
Matsuwaki Y, Wada K, White T, Moriyama H, Kita H. Int Arch Allergy Immunol 2012;158 Suppl 119-29

Recurrent anaphylactic reactions: an uncommon debut of lymphocytic hypophysitis.
Bobolea I, Guillen D, Barranco P, varez-Escola C, Quirce S. Int Arch Allergy Immunol 2012 May 4;159(1):103-106

Sensitization to common ragweed in Southern Bavaria: clinical and geographical risk factors in atopic patients.
Rueff F, Przybilla B, Walker A, Gmeiner J, Kramer M, Sabanes-Bove D, Kuchenhoff H, Herzinger T. Int Arch Allergy Immunol 2012 May 4;159(1):65-74

Paracetamol hypersensitivity: clinical features, mechanism and role of specific IgE.
Rutkowski K, Nasser SM, Ewan PW. Int Arch Allergy Immunol 2012 May 3;159(1):60-64

Spreading the word on food allergy education: lessons from childhood asthma.
Leo HL, Clark NM. J Pediatr 2012 Apr;160(4):540-541

Development and validation of educational materials for food allergy.
Sicherer SH, Vargas PA, Groetch ME, Christie L, Carlisle SK, Noone S, Jones SM. J Pediatr 2012 Apr;160(4):651-656

Food protein-induced enterocolitis syndrome in an exclusively breast-fed infant-an uncommon entity.
Tan J, Campbell D, Mehr S. J Allergy Clin Immunol 2012 Jan 30;

Comparable IgE reactivity to natural and recombinant Api m 1 in cross-reactive carbohydrate determinant-negative patients with bee venom allergy.
Jakob T, Kohler J, Blank S, Magnusson U, Huss-Marp J, Spillner E, Lidholm J. J Allergy Clin Immunol 2012 May 25;

Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness.
Patelis A, Gunnbjornsdottir M, Malinovschi A, Matsson P, Onell A, Hogman M, Alving K, Janson C. J Allergy Clin Immunol 2012 May 25;

Possible roles of 2 basidiomycetous fungi in allergic fungal respiratory disease.
Ogawa H, Fujimura M, Takeuchi Y, Makimura K. J Allergy Clin Immunol 2012 May 25;

Fungal and atopic sensitization are low among farmers in the Agricultural Health Study.
Endres SM, Green BJ, Henneberger PK, Germolec DR, Bledsoe TA, Beezhold DH, London SJ, Alavanja MC, Beane Freeman LE, Hoppin JA. J Allergy Clin Immunol 2012 May 25;

Parasites and allergic disease: Another piece of the puzzle.
Bush RK. J Allergy Clin Immunol 2012 May 12;

Adverse reactions to vaccines practice parameter 2012 update.
Kelso JM, Greenhawt MJ, Li JT, Nicklas RA, Bernstein DI, Blessing-Moore J, Cox L, Khan D, Lang DM, Oppenheimer J, Portnoy JM, Randolph CR, Schuller DE, Spector SL, Tilles SA, Wallace D. J Allergy Clin Immunol 2012 May 16;

Aspergillus species recombinant antigens for serodiagnosis of farmer's lung disease.
Millon L, Roussel S, Rognon B, Quadroni M, Salamin K, Reboux G, Barrera C, Fellrath JM, Aubert JD, Dalphin JC, Monod M. J Allergy Clin Immunol 2012 May 16;

Delayed-onset adenosine deaminase deficiency: Strategies for an early diagnosis.
Speckmann C, Neumann C, Borte S, la MG, Sass JO, Wiech E, Fisch P, Schwarz K, Buchholz B, Schlesier M, Felgentreff K, Grimbacher B, Santisteban I, Bali P, Hershfield MS, Ehl S. J Allergy Clin Immunol 2012 May 10;

Ascaris sensitization is associated with aeroallergen sensitization and airway hyperresponsiveness but not allergic disease in urban Africa.
Levin M, Muloiwa R, Le SP, Motala C. J Allergy Clin Immunol 2012 May 2;

High titers of IgE antibody to dust mite allergen and risk for wheezing among asthmatic children infected with rhinovirus.
Soto-Quiros M, Avila L, Platts-Mills TA, Hunt JF, Erdman DD, Carper H, Murphy DD, Odio S, James HR, Patrie JT, Hunt W, O'Rourke AK, Davis MD, Steinke JW, Lu X, Kennedy J, Heymann PW. J Allergy Clin Immunol 2012 May 4;

Over- and underestimated parameters in severe Hymenoptera venom-induced anaphylaxis: Cardiovascular medication and absence of urticaria/angioedema.
Stoevesandt J, Hain J, Kerstan A, Trautmann A. J Allergy Clin Immunol 2012 May 1;

Responses to ragweed pollen in a pollen challenge chamber versus seasonal exposure identifies allergic rhinoconjunctivitis endotypes.
Jacobs RL, Harper N, He W, Andrews CP, Rather CG, Ramirez DA, Ahuja SK. J Allergy Clin Immunol 2012 May 1;

Aspirin as a cause of pancreatitis in patients with aspirin-exacerbated respiratory disease.
Stevenson DD, White AA, Simon RA. J Allergy Clin Immunol 2012 May 1;

Induction and suppression of allergic diarrhea and systemic anaphylaxis in a murine model of food allergy.
Kucuk ZY, Strait R, Khodoun MV, Mahler A, Hogan S, Finkelman FD. J Allergy Clin Immunol 2012 May;129(5):1343-1348

Food allergy diagnostic practice in Italian children.
Berni CR, Nocerino R, Terrin G, Di CM, Cosenza L, Troncone R. J Allergy Clin Immunol 2012 May;129(5):1423-1424

Update on risk factors for food allergy.
Lack G. J Allergy Clin Immunol 2012 May;129(5):1187-1197

Spectrum of gluten-related disorders: consensus on new nomenclature and classification.
Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A. Miscellaneous BMC Med 2012 Feb 7;10:13.

A non-allergenic Ole e 1-like protein from birch pollen as a tool to design hypoallergenic vaccine candidates.
Marazuela EG, Hajek R, Villalba M, Barber D, Breiteneder H, Rodriguez R, Batanero E. Mol Immunol 2012 Feb;50(1-2):83-90

Respiratory, allergy and eye problems in bagasse-exposed sugar cane workers in Costa Rica.
Gascon M, Kromhout H, Heederik D, Eduard W, van Wendel de JB. Occup Environ Med 2012 May;69(5):331-338

Workplace interventions for treatment of occupational asthma: a Cochrane systematic review.
de Groene GJ, Pal TM, Beach J, Tarlo SM, Spreeuwers D, Frings-Dresen MH, Mattioli S, Verbeek JH. Occup Environ Med 2012 May;69(5):373-374

Parent perceived quality of life is age-dependent in children with food allergy.
Wassenberg J, Cochard MM, Dunngalvin A, Ballabeni P, Flokstra-de Blok BM, Newman CJ, Hofer M, Eigenmann PA. Pediatr Allergy Immunol 2012 May 3;

Primary school teachers' knowledge about and attitudes toward anaphylaxis.
Ercan H, Ozen A, Karatepe H, Berber M, Cengizlier R. Pediatr Allergy Immunol 2012 May 3;

Health-related quality of life does not explain the protective effect of farming on allergies.
Stocklin L, Loss G, von ME, Genuneit J, Horak E, Braun-Fahrlander C. Pediatr Allergy Immunol 2012 May 3;

A new quality of life scale for teenagers with food hypersensitivity.
Mackenzie H, Roberts G, Van LD, Dean T. Pediatr Allergy Immunol 2012 May 3;

A survey study of index food-related allergic reactions and anaphylaxis management.
Jacobs TS, Greenhawt MJ, Hauswirth D, Mitchell L, Green TD. Pediatr Allergy Immunol 2012 May 25;

Exposure to farming environments in childhood and asthma and wheeze in rural populations: a systematic review with meta-analysis.
Genuneit J. Pediatr Allergy Immunol 2012 May 25;

Fish and shellfish allergy in children: Review of a persistent food allergy.
Tsabouri S, Triga M, Makris M, Kalogeromitros D, Church MK, Priftis KN. Pediatr Allergy Immunol 2012 May 3;

Peanut sensitization during the first 5 yr of life is associated with elevated levels of peanut-specific IgG.
Sverremark-Ekstrom E, Hultgren EH, Borres MP, Nilsson C. Pediatr Allergy Immunol 2012 May;23(3):224-229

Antibacterial antibody responses associated with the development of asthma in house dust mite-sensitised and non-sensitised children.
Hales BJ, Chai LY, Elliot CE, Pearce LJ, Zhang G, Heinrich TK, Smith WA, Kusel MM, Holt PG, Sly PD, Thomas WR. Thorax 2012 Apr;67(4):321-327

Chickpea (Cicer arietinum) proteins induce allergic responses in nasobronchial allergic patients and BALB/c mice.
Verma AK, Kumar S, Tripathi A, Chaudhari BP, Das M, Dwivedi PD. Toxicol Lett 2012 Apr 5;210(1):24-33

Postinflammatory Hyperpigmentation After Skin Prick Testing. [Letter]
Ludman, Sian MRCPCH1; Penagos, Martin MD, MSc1; Brough, Helen A. MRCPCH1; Flohr, Carsten MRCPCPH, MSc, PhD1,2; Fox, Adam T. FRCPCH1 WAO Journal 2012;5(5):52-56

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