Ann Allergy. 1984 Dec;53(6 Pt 2):657-64.
Respiratory diseases and food allergy.
Heiner DC.
Abstract
Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect such as gastroesophageal reflux, a congenital defect of the heart or tracheo-bronchial tree, an immunodeficiency syndrome such as isolated IgA or IgG4 deficiency, or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy. When it occurs in conjunction with lung disease, it may be a helpful indicator of activity of the allergic lung disease and of the patient's compliance in following a specific diet. Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. Lower respiratory tract involvement is generally associated with a greater delay in onset of symptoms and with a larger quantity of allergen ingestion than chronic rhinitis. Food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 6239577 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/6239577

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Hum Nutr Appl Nutr. 1985 Aug;39(4):277-93.
Food allergy in childhood.
Cant AJ.
Abstract
Food allergy in childhood is a popular subject which has attracted disapprobation from certain quarters because of overinflated claims based on flimsy evidence. In this article food intolerance and allergy are defined and the pathogenesis of food allergic reactions is considered. There is a description of the role that food allergy may play in urticaria, angioedema, anaphylaxis, eczema, asthma, rhinitis, cow's milk sensitive enteropathy, infantile colitis, inflammatory bowel disease, migraine and hyperactivity. Factitious food allergy is discussed and the general unhelpfulness of 'allergy testing' commented upon. Finally there is a description of the use of various exclusion diets in the diagnosis and treatment of food allergic disorders. It is concluded that food allergy is important in an increasing number of childhood diseases, but it is not clear what proportion of children with a given condition will respond to dietary measures. The importance of ensuring that exclusion diets are nutritionally adequate is stressed, and there is a plea to remember that an exclusion diet might be worse than the disease itself.
PMID: 3900003 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/3900003
(Note the final sentence - for some of us, the exclusion diet is preferred to the condition and medical treatment - but for others, perhaps not - however, all available information should be presented for informed decision making)
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Acta Otolaryngol. 1999;119(8):867-73.
Cow's milk allergy is associated with recurrent otitis media during childhood.
Juntti H, Tikkanen S, Kokkonen J, Alho OP, Niinimäki A.
Author information

Abstract
To determine whether cow's milk allergy (CMA) in infancy is associated with recurrent otitis media (ROM) or other chronic ear infections, we conducted a cohort study by enrolling 56 milk-allergic and 204 control schoolchildren. We also studied the association between ear problems and different atopic manifestations. A higher proportion of children with CMA had had ROM. defined as at least 15 acute otitis media episodes by the age of 10 years (27%, vs 12%, p = 0.009), and had undergone adenoidectomy and or tympanostomy compared with the controls (48%, vs 28%, p = 0.005). However, this was only true of the children who had developed respiratory atopy. Asthma and/or allergic rhinitis, but not atopic dermatitis, posed a significant risk for ROM, while all the three atopic manifestations enhanced the risk for secretory otitis media. Positive skin prick tests with food, but not with inhaled allergens, tended to be associated with ear problems. In conclusion, we found that children with CMA in infancy, even when properly treated, had experienced significantly more ROM, the risk associating with concomitant development of respiratory atopy. PMID: 10728925 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/10728925
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Acta Paediatr. 2000 Oct;89(10):1174-80.
Status of children with cow's milk allergy in infancy by 10 years of age.
Tikkanen S, Kokkonen J, Juntti H, Niinimäki A.
Author information

Abstract
To assess the development of milk protein tolerance and atopic diseases in children diagnosed for cow's milk allergy (CMA) in infancy, we conducted re-examinations of 56 CMA subjects at the age of 10 y using 204 age-matched controls. The children underwent clinical examinations and skin prick tests (SPT), and their IgE-specific antibodies to milk and five other food allergens were determined. By the age of 10 y, all but four subjects had become tolerant to at least small amounts of milk protein. However, gastrointestinal symptoms relating to more abundant milk consumption were reported by 45% of the study subjects and 15% of the controls (p < 0.001). The incidence figures for asthma, allergic rhinitis and dermatitis, as well as the occurrence of recurrent otitis, were three to four times higher than in the controls. Positive SPTs were seen in two-thirds of the subjects, the figure being highest (83%) in those with dermatitis onset CMA. Seven subjects showed positive titres of IgE-class milk-specific antibodies, and five showed a clinical response.

CONCLUSION:

This re-examination study showed that CMA in infancy, even when properly treated, has significant clinical consequences by posing special risks for respiratory atopy and persistence of atopic dermatitis as well as positive SPT and recurrent ear infections. However, each of these clinical manifestations seems to have an independent curriculum unrelated to the persistence of CMA itself.
PMID: 11083371 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/11083371