Food+Allergy+in+a+toddler

Great job, I would like to repeat this assignment! I think it is good practice to proofread others' work! Thanks a lot for your work!!! tpe in the content of your page here. Carol Reamer- I may have done this wrong. Not sure if I quite understood the directions.

A 2 year-old girl is refered to an alergy an imunology clinic for food alergy. Four months ago, she ate cashew-nut containing candy and had an immediate alergic reaction which required a dose of benadril. Corrected by: Lindsey Vogel – my corrections are in the parentheses A 2 year-old girl is refered (referred) to an allergy (allergy) and imunology (immunology) clinic for food alergy (allergy). Four months ago, she ate cashew-nut containing candy and had an immediate alergic (allergic) reaction which required a dose of benadril (Benadryl).

Lindsey Vogel - So I re-did my assignment. When I read the directions the first time I didn't really understand the assignment until I re-read them a few more times and saw Carol's assignment. Sorry about the confusion!!

She was prascribed a trial of nebolized ilbuterol to be given up to every 4 hours PRN cough or wheze, and gauge its effectiveness in relieving her cough. If this does prove effective, we will likely need to add an ashtma controller agent such as inhaled corticosterod. Should this prove totally ineffective, then we may wish to pursue evaluations for other causes of night time cough such as chronic sinusitios, or GERD. For the mild ekzema, she may use 1% hydrecortisone cream b.i.d. to any areas of redness or inflimmation as needed.

corrected by Carol Reamer 1. prescribed 2. nebulizor 3. ibuteral 4. wheeze

5. asthma 6. corticosteroid 7. sinusitis 8. eczema 9. hydrocortisone 10. inflammation

** Teressa Millet ** Author: V. Dimov, M.D., Fellow, Creighton University Division of Allergy & Immunology Reviewer: S. Randhawa, M.D., Fellow, LSU (Shreveport) Department of Allergy & Immunology
 * Medical Terminology II **
 * April 14, 2010 **
 * Food Allergy in a Toddler **

A 2-year-old girl is referred to an allergy and immunology clinic for food allergy. Four months ago, she ate a cashew nut-containing candy and had an immediate myxedema which required a dose of Benadryl. She was placed on a strict nut elimination diet. Her pediatrician prescribed an Epicene Jr. for emergency use and ordered an Immunosuppressant titor for food allergens with a panel which included eggs, milk, wheat, corn, peanuts, soy, crab, shrimp, orange, and tuna. Significantly elevated allegy antigen titor were seen with peanut and egg white, and mildly elevated titers were seen with milk, wheat, soybean, and orange. The egg and peanut titers were sufficiently high to predict definite allergy, whereas the other low positive titers had a low probability of association with clinical allergy. Unfortunately, no tree nuts were obtained in that panel. She had been consuming milk and wheat-containing products without any reaction. Currently, she is being maintained on an egg, peanut, and nut-free diet, and has had no further allergic reactions.

**What is the most likely diagnosis?**

The patient has a significant history of tree nut allergy in the context of positive family medical history. The egg and peanut RAST titers were sufficiently high to predict definite allergy.

Night cough could be due to asthma or GERD. The occasional rash affecting the elbow and knee creases can be a manifestation of atopic dermatitis.


 * What diagnostic tests would you suggest?**

Skin testing.

Allergy skin testing was performed to house dust mites as well as tree nuts, and she did show strong reactions to all tree nuts tested, especially to cashew nut, pistachio nut, pecan, and walnut, and moderate reactions to almond and hazelnut. House dust mite was completely negative.


 * What happened?**

This 2-year-old girl has a clinical history of significant tree nut allergy, and skin test evidence of significant sensitization to tree nuts. She also has significantly elevated RAST titers to egg and peanut.

We recommended strict dietary elimination of these foods in all forms, and that the family be vigilant to read labels for ingredients that may indicate the presence of these allergens in her diet.

She should continue to keep EpiPen Jr. available for emergency use in case of a severe reaction related to accidental food allergen ingestion.

She was prescribed a a trial of nebulized albuterol to be given up to every 4 hours PRN cough or wheeze, and gauge its effectiveness in relieving her cough. If this does prove effective, we will likely need to add an asthma controller agent such as inhaled corticosteroid. Should this prove totally ineffective, then we may wish to pursue evaluations for other causes of night time cough such as chronic sinusitis, or GERD.