Food Allergy

Standar Kompetensi 4A

Definisi
Allergy: keadaan hipersensitivitas yang diinduksi oleh pajanan terhadap suatu antigen (alergen) tertentu yang menimbulkan reaksi imunologik berbahaya pada pajanan berikutnya Food allergy: alergi yang ditimbulkan oleh antigen yang dimakannya, seperti makanan maupun obat; yang paling sering adalah strawbery, susu dan telur. Organ yang terkena biasanya adalah kulit (dorlan)

Etiologi
Any food can cause an allergic reaction, but a few foods are the main culprits. The most common food allergies are to: (1) Eggs (mostly in children) Fish (older children and adults) Milk (mostly in children) Peanuts (people of all ages) Shellfish such as shrimp, crab, and lobster (people of all ages) Soy (mostly in children) Tree nuts (people of all ages) Wheat (mostly in children)

Faktor Resiko
Food allergy risk factors include: (2) Family history A past food allergy Other allergies Age Asthma

Manifestasi Klinik
Various sites on the body can be affected by an allergic reaction to food, including: (3) Eyes itching, watering Nose stuffiness, sneezing Mouth itching, swelling Throat swelling Digestive system stomach pains, vomiting, diarrhoea Skin rashes, such as hives (urticaria) or atopic dermatitis Lungs asthma, more common in children than adults Central nervous system headache, irritability, fatigue, convulsions.

Yang paling berat: reaksi anafilaksis Constriction and tightening of airways A swollen throat or the sensation of a lump in your throat that makes it difficult to breathe Shock, with a severe drop in blood pressure Rapid pulse Dizziness, lightheadedness or loss of consciousness

Patofisiologi
1. Fase sensitasi: waktu yg dibutuhkan untuk pembentukan IgE sampai diikat silang oleh reseptor spesifik (FcR) pada permukaan sel mast/basofil 2.Fase aktivasi: waktu yang diperlukan antara pajanan ulang dengan antigen yg spesifik dan sel mast/basofil melepas isinya yg berisikan granul yg menimbulkan reaksi. Terjadi krn ikatan silang antara antigen dan IgE 3. Fase efektor: waktu terjadi respon yg kompleks (anafilaksis) sebagai efek mediator yg dilepas sel mast/basofil

patomechanisme

Langkah Penegakan Diagnosa

1. Uji kulit Uji gores (scratch test), uji tusuk (Prick Skin Test/PST) dan uji suntik intradermal Uji kulit positif jika tumbuh indurasi, diameter 3mm 2. Laboratorium A. RAST ( Radio Allergosorbent Test) B. Konsentrasi total serum Ig E

3. Diet Eliminasi dan Uji Provokasi Mulai dari makanan netral atau non/hipoalergenik Makanan yang dicurigai dieliminasi selama 5hari, kemudian diuji provokasi 4. Uji Provokasi Buta ganda (UPBG) Uji standard terbaik Hasil negatif : menyingkirkan reaktivitas alergi

Penatalaksanaan
Currently, the only way to prevent a food-allergic reaction is to avoid the problem food. Mild to moderate symptoms (e.g., itching, sneezing, hives and rashes) are often treated with antihistamines and oral or topical steroids. For patients at risk of experiencing a severe reaction (anaphylaxis), epinephrine is prescribed. Steroids (e.g., cortisone) may be given, typically in the emergency room, to help reduce inflammation after an anaphylactic attack. Antihistamines, known as H1 blockers, are prescribed to relieve mild allergy symptoms, although they cannot control a severe reaction. Medications in this class include diphendydramine (Benadryl) and cetirizine (Zyrtec). An antihistamine can help symptoms subside during anaphylaxis, but it should never be given as a substitute for epinephrine. Asthma Medications. Short-acting bronchodilators (known as rescue inhalers), such as albuterol (Alupent, Proventil, Ventolin), may be used to help relieve breathing problems once epinephrine has been given, particularly if you are experiencing asthma symptoms.

Pencegahan
Hindari makanan penyebab Pemberian ASI dapat mengurangi insidens AM, karena adanya faktor proteksi, antibodi SIgA, faktor-faktor pertumbuhan yang mempercepat diferensiasi dan pematangan struktural dan fungsional saluran cerna.

Daftar Pustaka
1.http://www.nlm.nih.gov/medlineplus/ency/article/000817.htm 2.http://www.mayoclinic.com/health/food-allergy http://www.foodallergy.org/symptoms http://www.nhs.uk/Conditions/food-allergy/Pages/Symptoms.aspx http://www.webmd.com/allergies/guide/food-allergy-intolerances http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Food_all ergy_and_intolerance http://www.acaai.org/allergist/allergies/Types/food-allergies/Pages/foodallergy-symptoms.aspx