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Environmental skin-prick testing: A rapid, safe and easy way to identify whether a person’s symptoms are related to an allergy. Pricks are made on the skin surface using a small plastic device with a steel tip that contains commercially available allergens. No needles. No bleeding.
Food skin-prick testing: This test uses a small plastic device with a steel tip that either contains commercially available allergens or a small amount of the suspected food. No needles. No bleeding.
Food challenge: In a supervised setting, following a standardized protocol, a patient is given, in gradually increasing amounts, the food suspected of causing the allergic reaction to confirm or rule out a food allergy.
Patch testing: A set of adhesive patches are applied to the patient’s back and kept in place for 48 hours to evaluate delayed hypersensitivity reactions, either to foods or to contact allergens, such as nickel, rubber, or cosmetics.
Bee-venom testing: Through a series of skin tests, we evaluate the patient’s risk of allergic reaction to bees, wasps, hornets, and yellow jackets.
Environmental allergy immunotherapy: A series of injections are given at intervals that vary from one week to one month for three or more years. This induces a tolerance in the immune system, which diminishes or removes the symptoms of allergies caused by grass pollen, cat dander, or dust mites.
Bee-venom allergy immunotherapy: A series of injections are given at intervals that vary from one to six weeks for three or more years. This greatly reduces the risk of having a severe allergic reaction when a sting occurs.
Oral Immunotherapy (OIT): A supervised protocol in which increasing amounts of peanut or tree nuts are consumed, resulting in a state of decreased sensitivity for the patient. The goal of continued daily dosing is to create a “bite safe” level of protection.
These are exciting times for the treatment of peanut and tree nut allergies in children. Protocols that aim to desensitize patients to foods have moved from experimental to being available to patients across the country. Oregon Allergy Associates has been offering oral immunotherapy since 2018 and we have currently treated over seventy patients.
In a “nutshell”, desensitization patients are exposed to very small doses of their allergenic food, which build over time. Typically, patients will build to two grams of daily exposure over the course of 6-12 weeks. Patients from ages 3.5-18 can be considered for the typical build protocol. Slower protocols which build to maintenance in roughly 31 weeks are available for kids down to two years old. Studies have indicated that patients over 18 have trouble with the dosing and success is less likely.
Symptoms during buildup are generally expected but are mild in the majority of cases. Itching of the mouth and throat are common. Vomiting can occur in some cases and is treated with antacids and antihistamine. Breathing trouble or more serious symptoms are treated with an Epi-pen. About 1 in 20 patients has needed to use their Epi-pen at some point in therapy.
The goal of oral immunotherapy is to reduce the risk of symptoms with accidental exposure. Patients do not typically add the allergenic nut to their diet other than their daily, supervised dose at home.
If you have questions or think your child might be a good candidate for oral immunotherapy, please contact our oral immunotherapy nurses. They would be happy to schedule an appointment to discuss the possibility. FAQs are also available, upon request.
Spirometry: This lung-function test begins when a patient breathes forcefully into a tube, allowing the computer to recognize signs of asthma or other pulmonary conditions. A medicine, such as albuterol, is sometimes given; then the test is repeated to determine if any improvement.
Methacholine challenge: Used to rule out asthma, the patient is given a medicine to breathe that causes mild lung constriction. If a patient is unaffected, it is unlikely that patient suffers from asthma.
Exhaled nitric oxide: The patient breathes gently into a small machine that measures the amount of allergic inflammation in the lungs. This cutting-edge test can help determine if certain types of medicines might help control the patient’s asthma.
Rhinoscopy: This in-office procedure provides a detailed look at the nasal cavity. After the nose is numbed with an anesthetic spray, a small-diameter scope is passed through the nasal opening to look for evidence of nasal polyps, sinusitis, or other potential causes of nasal symptoms
Laryngoscopy: After the nose is numbed with an anesthetic spray, a small-diameter scope is passed through the nasal opening to provide a detailed look at the vocal cords and the surrounding structures.
EKG: To determine whether symptoms might have a cardiac cause, this test evaluates heart rhythm and function.
Wood’s Lamp: Special ultraviolet light is used to examine the skin lesion, which helps diagnose certain fungal or bacterial infections.
Here you will find links to reliable sources of information on allergy, asthma, and immunology topics.
American Academy of Allergy, Asthma, and Immunology
American College of Allergy, Asthma, and Immunology
Food Allergy and Anaphylaxis Network
American Latex Allergy Association
Immune Deficiency Foundation
Asthma and Allergy Foundation of America