© IPCRG 2007 IPCRG presentations on respiratory diseases Allergic disease: A practical approach in...
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© IPCRG 2007 IPCRG presentations on respiratory diseases Allergic disease: A practical approach in primary care
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Transcript of © IPCRG 2007 IPCRG presentations on respiratory diseases Allergic disease: A practical approach in...
© IPCRG 2007
IPCRG presentations on respiratory diseases
Allergic disease:A practical approach in primary care
Page 2 - © IPCRG 2007Page 2 - © IPCRG 2007© IPCRG 2007
• Common allergic conditions in primary care
Diagnosis prevention and testing Svein Høegh Henrichsen
• Aria Guidelines A practical approach The carat questionnaire
Jaime Correia de Sousa
Contents
© IPCRG 2007
Common allergic conditions in primary careDiagnosis?Prevention?
Svein Høegh Henrichsen G.P. Oslo, Norway
Researcher University of Oslo
Chair Norwegian College of General Practise
Working group on Respiratory Disease
Member Norwegian Governments Tobacco Council
Dermot Ryan
should also have definition of topy
Dermot Ryan
Atopy is a predisposition to developing hypersensitivity/allergy. an atopic is not necessarily allergic. allergy is the manifestation of atopy
Dermot Ryan
this slide describes the prevalenc eo fallergic disease, not atopy
Dermot Ryan
I would check whether ther is any evidence re GI tract: I think it is somewhat conjecture
Dermot Ryan
ref needed bousquet
Cumulative Threshold Disease
1. Pharmacia & Upjohn Diagnostics. The Value of Allergen Identification. 1998. Publication 98006.01.2. Ciprandi G, et al. J Allergy Clin Immunol. 1995;96:971-979.3. Boner AL, et al. Clin Exp Allergy. 1993;23:1021-1026.
Symptoms
No avoidanceMeasuresNormal ExposureNormal threshold
No avoidancemeasuresThird allergenIe.Increased exposureNormal threshold
Avoidance measuresemployedThird allergen
Cat dander
House dust mite
Birch pollen
Svein Høegh Henrichsen Norwegian College of General Practitionners Working Group on Respiratory Diseases
Cumulative Threshold Disease
1. Pharmacia & Upjohn Diagnostics. The Value of Allergen Identification. 1998. Publication 98006.01.2. Ciprandi G, et al. J Allergy Clin Immunol. 1995;96:971-979.3. Boner AL, et al. Clin Exp Allergy. 1993;23:1021-1026.
Symptoms
No avoidanceMeasuresNormal ExposureNormal threshold
No avoidancemeasuresThird allergenIe.Increased exposureNormal threshold
Avoidance measuresemployedThird allergenLowered threshold-Stress,infectionsIrritants,SMOKING
Cat dander
House dust mite
Birch pollen
© IPCRG 2007
Common allergic conditions in primary carePrevention?
Svein Høegh Henrichsen G.P. Oslo, Norway
Chair Norwegian College of General Practise
Working group on Respiratory Disease
Dermot Ryan
expin evidence for probiotics or other bacteria based products ( there is none)explain anthroposophic
Page 32 - © IPCRG 2007Page 32 - © IPCRG 2007© IPCRG 2007
Testing
• History and physical alone gives correct diagnosis only 50% of the time1
• Different causes demand different treatment
• Testing for specific IgE levels can rule in/out atopy
• If atopic:
– Antihistamines probably drug of choice
– Testing can help clinician in advising avoidance measures
• If non-atopic:
– Results will allow you to focus on other etiologies
– Drugs of choice may include decongestants/steroids
– Patient can avoid unnecessary/ineffective treatment
1. Homburger HA. Arch Pathol Lab Med. 2004;128:1028-1031.
Dermot Ryan
Dermot Ryan
not in primary care because of risk of anaphylaxis
Dermot Ryan
oral steroids?
Page 41 - © IPCRG 2007Page 41 - © IPCRG 2007© IPCRG 2007
Quantitative Measurements of spesific IgE/
• Blood test – easily done
• In vitro blood testing and skin prick testing (SPT)
viewed as equally good
• Regional respiratory profiles o Geographic pollen patterns
o Regional disease prevalence
o Cross reactivity to other allergens in each inhalant class
• Allergy March profiles include key food/inhalant allergenso Six foods account for 90% of food allergy reactions in children4
o Inhalants include common/cross-reactive indoor and outdoor allergens
o Generally recommended for children ≤6 years of age, based on symptoms
Dermot Ryan
when to use what?
© IPCRG 2007
Common allergic conditions in primary care -Treatment
Jaime Correia de Sousa
Dermot Ryan
a statement pointing to the dangers of first generation anti histamines needed here
Dermot Ryan
some modalities ar ein development to desensitise for peanut allergy
Dermot Ryan
local bronchial does not merit mention
Dermot Ryan
foods: chillies, spices, alcohol
Dermot Ryan
eosinophilia
Page 71 - © IPCRG 2007Page 71 - © IPCRG 2007© IPCRG 2007
Authors
• Jaime Correia de Sousa
• Svein Høegh Henrichsen
G.P. Oslo, Norway, Researcher University of Oslo
Chair Norwegian College of General Practise
Working group on Respiratory Disease
• Thanks to Dr. Ionna Tsiglianni , Dr. Catalina Panaitescu
and Dr Len Frommer for providing many of our slides
NEXT IPCRG MEETINGS
• IPCRG 3rd scientific meeting –
Uppsala 2013
23rd - 24th May in Uppsala (Sweden)
• IPCRG 7th IPCRG World Conference
Athens 2014
21st – 24th May in Athens (Greece)
