Food Hypersensitivity and Adverse Reactions : A Practical Guide for Diagnosis and Management (Clinical Allergy and Immunology) [Hardcover]

Marianne Frieri (Author), Brett Kettelhut (Author)

Book Description

ISBN-10: 0824799038 | ISBN-13: 978-0824799038 | Publication Date: June 15, 1999 | Edition: 1st

Presents classic and recent findings on immunological dysfunctions caused by food allergies-coordinating the most advanced clinical techniques and assessment methods with practical insights for treatment and patient care.

Editorial Reviews

From The New England Journal of Medicine

It is remarkable that more of us do not have immunologic diseases related to foods, considering the large amounts of foreign substances we are exposed to daily through our gastrointestinal tracts. Moreover, it is far from surprising that food is frequently suspected by patients as the cause of their symptoms. Indeed, some studies have estimated that up to 25 percent of households change dietary habits because at least one member is perceived to have food allergies. The true incidence of IgE-mediated hypersensitivity reactions to foods (food allergy) in developed countries is approximately 3 percent in infants (predominantly to milk, egg, and peanut) and about 1 percent in adults (predominantly to tree nuts and shellfish). Although many symptoms caused by eating certain foods probably do not have a true allergic or immunologic basis and are minor, it is salutary to note that true food allergy accounts for one third of all cases of anaphylaxis seen in hospital emergency rooms and that an estimated 100 deaths occur in the United States each year from food-induced anaphylaxis.

The subject of adverse reactions to foods encompasses a broad spectrum of clinical situations, ranging from misconstrued relations between food and symptoms, to symptoms caused by minor intolerance and mild allergic reactions, to hypersensitivity reactions that are immediate and life-threatening. Until relatively recently, the medical community was slow to acknowledge or investigate these disorders. As news items about fatal misadventures related to food allergies become more common, and as our understanding of food-related medical problems begins to increase dramatically, Food Hypersensitivity and Adverse Reactions: A Practical Guide for Diagnosis and Management provides a welcome and thorough update.

Food Hypersensitivity and Adverse Reactions is a remarkably comprehensive compendium of information on food allergies and other adverse reactions to foods. It bravely seeks to address issues related to adverse reactions to food from many different perspectives and aims to provide useful information to a broad readership, ranging from medical specialists in allergic diseases to patients and families troubled by food-related medical problems. It will almost certainly achieve those goals very well.

The book has 25 chapters, grouped into five sections. The first section deals predominantly with immune mechanisms in allergic disease. The strength of this section is its excellent content, which is often exquisitely detailed and is in general well referenced. Although it would fit well in any textbook on immunology and allergies, one might quibble that it provides little of immediate practical or clinical relevance to food allergy or intolerance and thus may be beyond what the nonspecialist might need. However, as wonderfully exemplified by the chapter on the biochemical structural characteristics of known food allergens (even though much of the detail seems indigestible), it will certainly serve as a useful reference for years to come.

The final section is an extremely useful source of practical information that will help practicing physicians and clinical assistants answer the day-to-day questions that frequently arise in the course of caring for patients with food-related diseases. Included are helpful sections on specific avoidance diets and infant formulas and lists of resources for practical information for patients.

The main substance of the book is in the second, third, and fourth sections, which include comprehensive discussions of the various foods that have been implicated in allergic or other adverse food reactions, hidden or cross-reactive allergens, and the role of food additives. Excellent accounts of the many common presentations of adverse food reactions are given. The authors do not shy away from discussing misconceptions that abound about the relations of symptoms to foods or from describing unusual clinical manifestations. Diagnostic approaches are explained clearly, with detailed descriptions of how to conduct food-challenge studies. Some contributions stand out: the discussion of delayed and non-IgE-mediated reactions, for its thoroughness and excellent case histories; the chapter on psychological manifestations, for its structured approach to a topic sometimes handled poorly in clinical practice; and the discussion of unproven diagnostic methods, which is both thoughtful and fair.

As is common in multiauthored books, Food Hypersensitivity and Adverse Reactions both benefits and suffers from variations in style and detail and from an overlap of content among the contributions. Several of the chapters do not synthesize the data presented and do not contain conclusions, appearing as little more than catalogs of the published literature. In an emerging field, this difficulty in drawing unifying conclusions reflects the nature of the science, in which most of the medical and scientific data published are descriptive only, more than it does any shortcomings on the part of the authors. The information remains useful, nevertheless, because the interpretation of new data is far easier when existing data have already been comprehensively and lucidly compiled for comparison. Only through careful scrutiny of the existing observations will we better understand the questions to which we seek answers.

The evaluation and management of adverse reactions to food, including true allergy to food, is difficult for clinicians. It is even more difficult for patients and their families, because our ability to help is limited. Treatment revolves around the avoidance of offending food and the treatment of the symptoms of exposure. The era of disease modification remains distant. Having thorough, up-to-date reviews of the many facets of this area of clinical practice in a single textbook will be valuable. This compendium very successfully lays out the many facets of the problem with cogency. It represents a substantial achievement and will repeatedly reward its multi-tiered readership well. I am certain it will become a much-thumbed reference book in my office.

Reviewed by Aidan Long, M.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

. . .The presentation of neurologic, autoimmune and psychological topics provide information for an integrated team approach in evaluating the food-allergic patient.
---Food Trade Review
. . .This compendium very successfully lays out the many facets of the problem with cogency. It represents a substantial achievement and will repeatedly reward its multi-tiered readership well.. . .it will become a much-thumbed reference book. (New England Journal of Medicine) . . .Having thorough up-to-date reviews of the many facets of [adverse reactions to foods] in a single textbook will be valuable. This compendium very successfully lays out the many facets of the problem with cogency. It represents a substantial achievement and will repeatedly reward its multi-tiered readership well.. . .it will become a much-thumbed reference book.
---New England Journal of Medicine
...an excellent, comprehensive source of information.
---The Annals of Pharmacotherapy

Product Details

• Hardcover: 507 pages
• Publisher: CRC Press; 1st edition (June 15, 1999)
• Language: English
• ISBN-10: 0824799038
• ISBN-13: 978-0824799038
• Product Dimensions: 9.3 x 6.2 x 1.1 inches
• Shipping Weight: 1.6 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #2,897,600 in Books (See Top 100 in Books)