Updates on food-related diseases

Although our national meeting in Philadelphia was cancelled, new updates on food-related diseases are constantly being reported and updated.

So what are the new updates?

Food Allergy

  • PEANUT- emphasis on prevention, early diagnosis, and treatment. There is more emphasis on shared-decision making in pediatric food allergy among the parents, patient, and doctor.
    • New kit for OIT (oral immunotherapy) approved by FDA
    • Rapid versus slow desensitization (European  no Epipen use and no EoE)
    • New diagnostic tools to differentiate true food allergy versus food sensitivity
    • Tree nut allergy is increasing worldwide and considered to be lifelong. OIT is available for multiple foods, including tree nuts.


  • The international consensus guidelines for the diagnosis and management was published in April 2017 in JACI.
  • It is a non-IgE (allergy antibody) mediated disease, but 5-30% of infants have IgE (allergy antibody) present. It is important that we do allergy skin testing to identify patients who have food specific IgE. The prognosis is different in these patients.

Red Meat Allergy (Alpha-gal syndrome)

  • This unusual syndrome was initially reported only in Eastern United States. It is more common in Tulsa than in OKC but it is moving towards OKC and we have diagnosed several patients already.
  • This allergy is transmitted by a tick bite.
  • Interesting to note that the course of the disease is very variable.


  • AGA (American Gastroenterological Association) and the Joint Force on allergy-immunology practice parameters clinical guidelines for the management of EoE was published in May of this year. There is lots of ongoing research at this time. Cromolyn proved to be ineffective. In a phase 2 study involving IL4 and IL13 (biologics) normalized histology in 78% of the patients.

American Initiative in Mast Cell Diseases

I had the honor to attend the Inaugural Investigator Conference in May 2019 at Stanford University. AIM will establish a network that will collaborate with Mastocytosis Society and the already established European Competence Network on Mastocytosis (ECNH). During the conference, we discussed updates, mast cell biology, mast cell activation, clinical heterogeneity, types and treatments of mast cell diseases. Dr. Mariana Castells from Harvard was one of the members of AIM Steering Committee and a keynote speaker. She has been one of our consultants to help with officially diagnosing and treating mast cell diseases. It was a thrill to participate in the conference.

American Initiative in Mast Cell Diseases website

Shared Decision Making

Recently in the Annals of Allergy, Asthma & Immunology 2019, there was a review page on Shared Decision Making (SDM) for the allergist. SDM is a process by which patients and healthcare providers join together to choose the best treatment option for the patient. My philosophy is 100% in agreement with the conclusion made in the paper. Effective SDM has been shown to lead to better outcomes. SDM should be universally implemented as a key component of patient centered healthcare.