Japanese guidelines for food allergy 2017

Abstract

Five years have passed since the Japanese Pediatric Guideline for Food Allergy (JPGFA) was first revised in 2011 from its original version. As many scientific papers related to food allergy have been published during the last 5 years, the second major revision of the JPGFA was carried out in 2016. In this guideline, food allergies are generally classified into four clinical types: (1) neonatal and infantile gastrointestinal allergy, (2) infantile atopic dermatitis associated with food allergy, (3) immediate-type of food allergy (urticaria, anaphylaxis, etc.), and (4) special forms of immediate-type of food allergy such as food-dependent exercise-induced anaphylaxis and oral allergy syndrome (OAS). Much of this guideline covers the immediate-type of food allergy that is seen during childhood to adolescence. Infantile atopic dermatitis associated with food allergy type is especially important as the onset of most food allergies occurs during infancy. We have discussed the neonatal and infantile gastrointestinal allergy and special forms of immediate type food allergy types separately. Diagnostic procedures are highlighted, such as probability curves and component-resolved diagnosis, including the recent advancement utilizing antigen-specific IgE. The oral food challenge using a stepwise approach is recommended to avoid complete elimination of causative foods. Although oral immunotherapy (OIT) has not been approved as a routine treatment by nationwide insurance, we included a chapter for OIT, focusing on efficacy and problems. Prevention of food allergy is currently the focus of interest, and many changes were made based on recent evidence. Finally, the contraindication between adrenaline and antipsychotic drugs in Japan was discussed among related medical societies, and we reached an agreement that the use of adrenaline can be allowed based on the physician's discretion. In conclusion, this guideline encourages physicians to follow the principle to let patients consume causative foods in any way and as early as possible.

Predictors of Persistent Wheat Allergy in Children: A Retrospective Cohort Study

“…Wheat allergy is the third most common food allergy that develops during infancy in Japan [10, 11]. Although research groups such as Keet et al [12] and Czaja-Bulsa et al [13] have previously reported on the wheat allergy history exhibited by patients in Western populations, the topic has been poorly studied in Asian (including Japanese) populations.…”

Specific IgE for Fag e 3 Predicts Oral Buckwheat Food Challenge Test Results and Anaphylaxis: A Pilot Study

“…Treatments for provoked reaction were based on the European Academy of Allergy and Clinical Immunology's food allergy and anaphylaxis guidelines [9]. Anaphylaxis was defined according to World Allergy Organization Anaphylaxis Guidelines [10], and severity of symptoms was defined according to Japanese anaphylaxis guidelines [8,11].…”

“…In total, 64 g of BW noodles containing 3,072 mg of BW protein were used for OFC as previously described [4] (based on the 2017 Japanese Pediatric Guidelines for Food Allergy [8]). Treatments for provoked reaction were based on the European Academy of Allergy and Clinical Immunology's food allergy and anaphylaxis guidelines [9].…”

Світовий Досвід Використання Бацил, Що Утворюють Спори, Для Лікування І Профілактики Харчової Алергії У Дітей

“…При этом следует учитывать, что частота аллергиче-ских заболеваний варьирует в зависимости от воз-раста пациентов. Распространенность пищевой ал-лергии оценивается в 5-10 % у младенцев, 3-5 % -у детей младшего возраста и 4,5 % -у школьников [2]. У маленьких детей наиболее частой локализацией аллергического процесса является пищеваритель-ный тракт (например, пищевая аллергия), что кли-нически проявляется симптомами поражения кожи и слизистых оболочек.…”