Clinical allergy and immunology:
food hypersensitivity and adverse reactions

A Practical Guide For Diagnosis and Management.
Edited by Marianne Frieri and Brett Kettelhut
Book Review By Hoffman Center Staff

Food Allergy is a hot topic in health care. Some doctors only believe in immediate or anaphylaxis reactions, while others believe in the addition of delayed food allergies. The text Clinical Allergy and Immunology: Food Hypersensitivity and Adverse Reactions, A Practical Guide For Diagnosis and Management, sheds light on the diverse subject of food allergy, and can be viewed as a bridge between the two schools of thought. This professional text assists the practitioner with regard to identification, treatment, and various functions of food allergy and intolerance.

While there will most likely continue to be confusion amongst practitioners with regard to the diagnosis of food allergy, this clinical text offers such a wide variety of research, that health care providers are treated to a ground up approach to this vast science. The text is divided into five parts. Parts I and II are considered the basic science section, and reviews the allergic and immunologic basis for food allergy. This can be an important review for many doctors that are either unaware of non-IgE mediated dietary allergy (IgE, a specific immune system component, is the most common way to identify food allergies). I am pleased by the inclusion of such a review, since I feel that it is imperative for practitioners of the healing arts to be aware of non-IgE mediated manifestations of food allergy, and delayed hypersensitivity. The criteria of misdiagnosis can clearly shadow the symptomatology associated with other immunological reactions. For this reason, it is the utmost importance for the practitioner to be vigilant of such complex etiology.

The clinical section found in parts III and IV, discusses clinical manifestations of food allergy including prevalence, unusual presentations, diagnosis, prevention, and treatment, in full detail. The connection between many illnesses and food allergy is clearly represented by the full explanation of many health conditions and dietary allergy or intolerance. Chapters devoted to specific foods, such as cow's milk allergy and related conditions including gastrointestinal, dermatological, and respiratory abnormalities are included. A chapter on adverse reactions to food additives provides lists, immune response markers, and conditions associated with these ubiquitous additions to our daily diets. Even the controversial topic of transgenic crops is explained. The authors argue that transfer proteins from other species, which can't be ordinarily achieved by traditional breeding techniques, promote the risk of allergenicity for the consumer.

Importantly, part V of the text lists food and food component avoidance lists for an individual diagnosed with a specific food allergy, such as wheat, egg, milk, and corn. Similar lists are provided for the individual experiencing cross reactivity between allergens. Meaning, people allergic to one food in a biological class may also be allergic to other foods in that class.

Over the span of 25 chapters and 507 pages, Clinical Allergy and Immunology: Food Hypersensitivity and Adverse Reactions, A Practical Guide For Diagnosis and Management, offers readers more than just the technical aspect of food allergy. The addition of detailed lists for the individual diagnosed with a specific food allergy, and cross reactive food allergy, plus including a full section on patient resources, makes this text extremely valuable for the practitioner and patient.