BSACI 2021 guideline for the management of egg allergy.

This guideline advises on the management of patients with egg allergy. Most commonly egg allergy presents in infancy, with a prevalence of approximately 2% in children and 0.1% in adults. A clear clinical history will confirm the diagnosis in most cases. Investigation by measuring egg-specific IgE (by skin prick testing or specific IgE assay) is useful in moderate-severe cases or where there is diagnostic uncertainty. Following an acute allergic reaction, egg avoidance advice should be provided. Egg allergy usually resolves, and reintroduction can be achieved at home if reactions have been mild and there is no asthma. Patients with a history of severe reactions or asthma should have reintroduction guided by a specialist. All children with egg allergy should receive the MMR vaccine. Most adults and children with egg allergy can receive the influenza vaccine in primary care, unless they have had anaphylaxis to egg requiring intensive care support. Yellow Fever vaccines should only be considered in egg-allergic patients under the guidance of an allergy specialist. This guideline was prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and is intended for allergists and others with a special interest in allergy. The recommendations are evidence based. Where evidence was lacking, consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, diagnosis, treatment, prognosis and co-morbid associations.

Illness perception of adolescents with allergic conditions under specialist care.

BACKGROUND: Our understanding of how adolescents perceive and cope with their allergic condition/s is limited. This study used the Brief Illness Perception Questionnaire (BIPQ) in a group of adolescents with allergies and correlates the findings with demographic and clinical conditions. METHODS: In this retrospective questionnaire-based study, we analysed 100 valid questionnaires from adolescents (11-18 years) attending our service after receiving management and treatment for their allergic condition/s. RESULTS: The overall BIPQ score was 4.8 (IQR 3.6-5.6). The highest item-related scores were for "timeline" (illness duration) followed by "concern." The lowest scores were found for "coherence/understanding," demonstrating that adolescents do not perceive that they have a sound understanding of their condition/s. We found a significant difference in the overall BIPQ scores between the genders and in the emotional representation score, with females showing a highest score. Older adolescents reported a more chronic perception of the allergic disease/s. CONCLUSION: Our results suggest that a better understanding and support of the allergic condition/s in adolescents, particularly in females, are likely an important target for intervention intended to improve their quality of life. BIPQ can be used as adjunct to routine allergy clinic appointments for further exploration of the wider impact of allergies on adolescents' lives.

Psychological services for food allergy: The unmet need for patients and families in the United Kingdom.

Research over the past 20 years has demonstrated the significant impact food allergy can have on quality of life and mental health of patients and their families, yet there is a paucity of psychological services to support families in coping with this condition. This paper provides a short overview of the psychological impact of food allergy, followed by a discussion of the use of paediatric psychological services for long-term conditions. To our knowledge, few paediatric allergy clinics in the UK have funding for dedicated clinical psychology services. Two such services are based at Southampton General Hospital and the Evelina London Children's Hospital. This paper includes descriptions of these services and how they are currently being used by patients and families. This is followed by an allergy clinician's perspective on the use of psychological services. Recommendations are made for allergy services to work with hospital psychology services to develop, integrate and deliver psychological services for all patients with allergy and their families who are in need. Future research also needs to focus on the efficacy of psychological therapies and group interventions in food allergy.