Q I’m severely allergic to dairy. Is there treatment or cure on the horizon for people like me?

A There are a lot of promising studies being conducted on food allergies, particularly related to peanut allergy. On the dairy front, researchers at Johns Hopkins recently attempted to desensitize older children and adults who had documented IgE-anaphyalaxis to cow’s milk. These patients were given increasing oral doses of milk in a controlled setting over a period of time. At the close of the study, many of those treated experienced mouth itching and some throat discomfort when ingesting milk, but ultimately, 40 to 50 percent of them could safely tolerate more than a few ounces of milk.

These exciting findings offer hope but many questions remain. How long do the effects of desensitization last? How many patients relapse and have an anaphylactic reaction? How do very young children respond to desensitization?

A word of caution: Several study participants required epinephrine and other medical intervention, a reminder that this technique is still in the investigation stage and should not be tried outside a controlled research setting.
    –Dr. Leo

Q We’re remodeling our bathroom and found some mold behind a wall. Should we be worried?

A Mold can occur naturally in damp places like bathroom showers or kitchen backsplashes. Several types can pose a health hazard to susceptible individuals. The best known culprit is Stachybotrys, characterized by its black, blanket-like appearance. Spores from this mold release a toxin that’s detrimental to humans, particularly with prolonged exposure. A study conducted ten years ago identified a rare reaction to this mold in the lungs of young infants, causing serious breathing issues. Parents of young children exposed to this mold should check with their doctor.

Many people suffer allergic symptoms, such as itchy, runny nose and eyes, breathing trouble, etc., to outdoor seasonal molds. The most studied is Alternaria sp, a mold found in the soil which releases spores on dry, windy days in late summer. Experts have linked Alternaria sp. blooms with an increase in emergency room visits by asthmatics.

If you suspect mold exposure in your home, hire a reputable mold remediation company to investigate and remove it and be certain to discuss your health concerns with your doctor.
    –Dr. Leo

Q My child was just diagnosed with food protein induced enterocolitis syndrome. Is this like a food allergy?

A Food protein induced enterocolitis syndrome, or FPIES, differs from a standard food allergy in a variety of ways. Children with this problem have a very specific reaction to the foods they’re sensitive to, usually dairy and soy. Often, the reaction occurs in infants who are transitioning from breast milk to formula before their first birthday but FPIES can also be caused by solid foods.

Children with FPIES typically begin vomiting 2 to 3 hours after ingesting even small quantities of the problem food. They may also develop diarrhea. Vomiting is often very severe and can continue even after the stomach is empty, with the child retching for an hour or more after the reaction starts. The youngster can become dehydrated and develop low blood pressure requiring IV fluids. Unlike other types of food allergy reactions, kids with FPIES do not develop hives, swelling, congestion or breathing problems.

Unfortunately, there are no tests to confirm that a child has FPIES; the only way to diagnose it is by medical history. This can lead to a delay in diagnosis, particularly if the doctor doesn’t know about this relatively uncommon condition. The actual incidence of FPIES is not known but in my practice it represents less than 1 percent of the food-allergic kids I treat.

Like other types of food allergies, avoidance of food culprits is extremely important. It’s also recommended that children with FPIES avoid other foods, such as grains (including rice and oats), poultry and lentils. The reason is that FPIES kids have a higher risk of reacting if these foods are introduced into their diet at too young an age.

Fortunately, most kids with FPIES do outgrow the condition. It’s estimated that 60 percent of FPIES kids who react to cow’s milk outgrow the allergy by the age of two. It can take a little longer to outgrow reaction to other foods.
    –Dr. Jain

Q My father started taking glucosamine and had an allergic reaction. What could he be allergic to?

A Glucosamine and chondroitin supplements, helpful to many people with osteoarthritis, are often made with seafood products. If your father has a sensitivity or allergy to fish or shellfish, he is likely reacting to these ingredients in the supplements. It is essential that anyone with a food sensitivity or allergy carefully check ingredients before taking medication or supplements.
    –Dr. Leo

Q There are some walnut trees in our new neighborhood. My daughter is allergic to most tree nuts. Will this be a problem?

A Outdoor weather can degrade the allergenic proteins in the walnuts but keep your child clear of them. If she accidentally touches a shell, thoroughly wash her hands and observe her closely for a reaction. If she has a history of anaphylaxis to walnuts, be vigilant and keep an EpiPen handy. Instruct your daughter about the nuts and make sure she understands how to spot them, how to avoid them and what to do should there be a reaction.

People who are tree nut allergic generally do not react to contact with the bark, sap or leaves of the tree. But keep in mind that some may have a seasonal allergy to the tree pollen.
    –Dr. Leo