{"title":"[History and physycal examination].","authors":"Silvana Beatriz Monsell, María Cristina Diaz","doi":"10.29262/ram.v70i4.1333","DOIUrl":null,"url":null,"abstract":"<p><p>The most effective method for diagnosing food allergy is the clinical history, which includes anamnesis and physical examination. The anamnesis must include a directed and detailed questioning, and together with the physical examination, it will provide the necessary data to guide the diagnosis and suggest whether the pathophysiology is mediated or not by IgE, which is relevant for the selection and interpretation of the tests. specific and establish the accurate diagnosis, in addition to evaluating the possibility of distinguishing between the different differential diagnoses. It is important to assess the clinical history, because no in vivo or in vitro test is relevant if it is not confirmed with it. Even if there is a strong history of food allergy detected in the history, positive tests can confirm the diagnosis without the need for oral challenge, thus avoiding the risk and cost of performing it. The expression of food allergy is influenced by non-modifiable risk factors that include sex, race and genetics (familial), and modifiable factors: atopic dermatitis, vitamin D deficiency, diet high in polyunsaturated fats and deficient in antioxidants, consumption of antacid drugs, obesity, increased hygiene, influence of the microbiota, time and route of food exposure (increased risk by delaying oral ingestion of allergens and concomitant environmental exposure of the same that leads to sensitization and allergy).</p>","PeriodicalId":101421,"journal":{"name":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","volume":"70 4","pages":"234-237"},"PeriodicalIF":0.0000,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista alergia Mexico (Tecamachalco, Puebla, Mexico : 1993)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29262/ram.v70i4.1333","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
The most effective method for diagnosing food allergy is the clinical history, which includes anamnesis and physical examination. The anamnesis must include a directed and detailed questioning, and together with the physical examination, it will provide the necessary data to guide the diagnosis and suggest whether the pathophysiology is mediated or not by IgE, which is relevant for the selection and interpretation of the tests. specific and establish the accurate diagnosis, in addition to evaluating the possibility of distinguishing between the different differential diagnoses. It is important to assess the clinical history, because no in vivo or in vitro test is relevant if it is not confirmed with it. Even if there is a strong history of food allergy detected in the history, positive tests can confirm the diagnosis without the need for oral challenge, thus avoiding the risk and cost of performing it. The expression of food allergy is influenced by non-modifiable risk factors that include sex, race and genetics (familial), and modifiable factors: atopic dermatitis, vitamin D deficiency, diet high in polyunsaturated fats and deficient in antioxidants, consumption of antacid drugs, obesity, increased hygiene, influence of the microbiota, time and route of food exposure (increased risk by delaying oral ingestion of allergens and concomitant environmental exposure of the same that leads to sensitization and allergy).
诊断食物过敏最有效的方法是临床病史,包括询问病史和体格检查。病史必须包括有针对性的详细询问,并与体格检查一起提供必要的数据,以指导诊断,并提示病理生理学是否由 IgE 介导,这与试验的选择和解释相关。对临床病史进行评估非常重要,因为如果没有临床病史的证实,任何体内或体外试验都没有意义。即使在病史中发现了食物过敏的病史,阳性检测也可以确诊,而无需进行口腔挑战,从而避免了进行口腔挑战的风险和成本。食物过敏的表现受不可改变的风险因素影响,包括性别、种族和遗传(家族性),以及可改变的因素:特应性皮炎、维生素 D 缺乏、多不饱和脂肪含量高且缺乏抗氧化剂的饮食、服用抗酸药物、肥胖、卫生条件改善、微生物群的影响、接触食物的时间和途径(延迟口服过敏原和同时接触导致过敏和过敏的环境会增加风险)。