𝐓𝐨𝐝𝐚𝐲'𝐬 𝐩𝐨𝐬𝐭 𝐢𝐬 𝐟𝐮𝐥𝐥 𝐨𝐟 𝐦𝐢𝐱𝐞𝐝 𝐟𝐞𝐞𝐥𝐢𝐧𝐠𝐬:
Many of you have never heard of 𝐌𝐚𝐬𝐭 𝐂𝐞𝐥𝐥 𝐀𝐜𝐭𝐢𝐯𝐚𝐭𝐢𝐨𝐧 𝐃𝐢𝐬𝐨𝐫𝐝𝐞𝐫 or, in fact, all other mast cell disorders that exist.
𝘔𝘢𝘴𝘵 𝘤𝘦𝘭𝘭𝘴 are an important part of our immune system, and we could not survive without them.
It is thought the way this line of cells has evolved was mainly to fight against invasion and proliferation of 𝘱𝘢𝘳𝘢𝘴𝘪𝘵𝘦𝘴 in the human gut.
Now it works as the main mediator for allergic diseases but also to fight infections.
Only recently (around 𝟐𝟎𝟎𝟕) it has been named a known disorder and, due to that, its incidence and other epidemiological information are really not known.
As a rough idea Mastocytosis (another Mast Cell disorder) is thought to affect between 𝟓 𝐭𝐨 𝟏𝟎 cases per 1 million world population per year.
As 𝘔𝘢𝘴𝘵𝘰𝘤𝘺𝘵𝘰𝘴𝘪𝘴 is more common than 𝘔𝘊𝘈𝘚, we can only imagine how many cases are diagnosed worldwide per year. The rest of the data might be comparable, but it is not truly known.
Treatment is focused on a decrease of symptoms and trying to prevent as many 𝘈𝘯𝘢𝘱𝘩𝘺𝘭𝘢𝘤𝘵𝘪𝘤 episodes as possible.
Please do remember that MCAS's symptoms overlap with plenty of other conditions, mainly 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐒𝐩𝐨𝐧𝐭𝐚𝐧𝐞𝐨𝐮𝐬 𝐔𝐫𝐭𝐢𝐜𝐚𝐫𝐢𝐚(𝐂𝐒𝐔) and 𝐂𝐡𝐫𝐨𝐧𝐢𝐜 𝐒𝐩𝐨𝐧𝐭𝐚𝐧𝐞𝐨𝐮𝐬 𝐀𝐧𝐠𝐢𝐨𝐞𝐝𝐞𝐦𝐚 (𝐂𝐒𝐀).
Soon I will also talk about this condition, which is fairly frequent.
So, if you believe your child, or someone you know, fits into the signs and symptoms I speak about here, please do ask for a referral to either a 𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐀𝐥𝐥𝐞𝐫𝐠𝐢𝐬𝐭 or an 𝐀𝐝𝐮𝐥𝐭 𝐀𝐥𝐥𝐞𝐫𝐠𝐢𝐬𝐭.
You might think the answer is obvious, but you would be surprised.
I still receive referrals to my allergy clinic asking patients to be tested as they might have a coeliac allergy!
𝐂𝐨𝐞𝐥𝐢𝐚𝐜 𝐝𝐢𝐬𝐞𝐚𝐬𝐞 is a serious pathology where the body's immune system attacks itself.
𝗪𝐡𝐞𝐚𝐭 𝐚𝐥𝐥𝐞𝐫𝐠𝐲 is a reaction to proteins found in wheat. It can be either IgE (immediate) or non-IgE (delayed).
𝐍𝐂𝐆𝐈/𝐍𝐂𝐆𝐒 has symptoms similar to coeliac disease. Still not well known if or how the immune system is involved. There doesn't seem to have damage to the lining of the gut.
Gluten is a protein found in cereals.
How to investigate and diagnose:
It is an Allergy or an Intolerance?
In a milk allergy, the body reacts to milk proteins, not milk sugar.
In lactose intolerance, there is little to no lactase (an enzyme produced by our body), so the milk sugar (lactose) cannot be digested.
Cow's milk protein allergy (CMPA) affects from 2 to 6% of children, with the highest prevalence during the first year of age.
Lactose intolerance has 4 types:
The tests for both are different.
Obviously, the symptoms are also different.
If you or your child have an immediate reaction to a food, avoid it and ask for a referral to either a Paediatric Allergist or an Adult Allergist.
In case the reactions are delayed (2 hours to several days), your best option is to be seen by either a Paediatric Dietitian or an Adult Dietitian.
A common source of debate, misconception and confusion is "𝘤𝘢𝘯 𝘮𝘺 𝘤𝘩𝘪𝘭𝘥 𝘣𝘦 𝘷𝘢𝘤𝘤𝘪𝘯𝘢𝘵𝘦𝘥 𝘪𝘧 𝘩𝘦/𝘴𝘩𝘦 𝘩𝘢𝘴 𝘢𝘯 𝘦𝘨𝘨 𝘢𝘭𝘭𝘦𝘳𝘨𝘺?".
Especially now with the circulating Pfizer and AstraZeneca (Oxford) COVID19 vaccines, many have asked me about their safety.
But let's start with the basics.
𝐒𝐨 𝐰𝐡𝐲 𝐢𝐬 𝐢𝐭 𝐭𝐡𝐚𝐭 𝐦𝐨𝐬𝐭 𝐨𝐟 𝐭𝐡𝐞𝐦 𝐮𝐬𝐞 𝐡𝐞𝐧𝐬' 𝐞𝐠𝐠𝐬?
The process of growing a virus in an egg leads to that virus becoming less infectious to the human being, but still leading to a protective effect against potential infections in the future.
After a virus is injected, the egg will be sealed with gelatine. This is normally made from pork protein.
On the process of collecting the grown virus from the egg, a small amount of protein will come along as well. This can potentially lead to an allergic reaction.
Saying this, other components might lead to allergic reactions.
𝘛𝘩𝘦 𝘚NIFFLE 𝘴𝘵𝘶𝘥𝘪𝘦𝘴 have shown the safety of the Nasal Flu vaccine.
Several studies have shown that the LAIV (Live Attenuated Influenza Vaccine) that contain less than 0.12μg/mL (so 0.06 μg for a 0.5 mL dose) is safe for patients with an egg allergy.
To produce this vaccine, the virus is grown on chick embryonic fibroblast cells.
In case a patient with an egg allergy needs this vaccine, there two other options that can be used, as they do not contain egg:
𝐘𝐞𝐥𝐥𝐨𝐰 𝐟𝐞𝐯𝐞𝐫 𝐯𝐚𝐜𝐜𝐢𝐧𝐞
Finally, the COVID19 vaccines:
The only children who need to be vaccinated in a hospital are those with an allergy to eggs, with previous anaphylaxis to egg or who had a cardiorespiratory reaction needing admission to Intensive Care or those with coexisting active, chronic asthma.
Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.