Browsing by Author "Leickly, Frederick E."

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    Multisystem reactions during egg oral food challenges may be associated with less severe reactions on initial presentation
    (Springer (Biomed Central Ltd.), 2016) Vitalpur, Girish; Esquivel, Ann; Kloepfer, Kirsten M.; Slaven, James E.; Leickly, Frederick E.; Department of Pediatrics, IU School of Medicine
    In this study, we assessed whether multisystem reactions to egg and extensively-heated (EH) egg during OFCs were associated with a history of multisystem reactions. Records of children, who underwent OFC to egg or EH egg over a five-year period were reviewed. Of the 120 challenges, 26 (21.67 %) failed, with 38.4 % (10/26) having multisystem reactions. Of the 13 who had multisystem reactions on initial presentation, only two (15.4 %) had a similar OFC outcome. Eighty percent (8/10) of those who had a multisystem OFC reaction had a less severe initial presentation. Initial and OFC multisystem reactions were not associated with each other.
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    Oral Food Challenge Failures Among Foods Restricted Due to Atopic Dermatitis
    (Elsevier, 2018) Eapen, A. A.; Kloepfer, Kirsten M.; Leickly, Frederick E.; Slaven, James E.; Vitalpur, Girish; Pediatrics, School of Medicine
    BACKGROUND Recent studies have suggested that removing foods from the diet to manage atopic dermatitis (AD), based on positive allergy tests, may lead to immediate allergic reactions on reintroduction of that food. OBJECTIVE The purpose of this study was to examine the frequency of oral food challenge (OFC) failures among foods removed from the diet as suspected AD triggers, focusing on the five major food allergens in the US. METHODS OFCs to egg, milk, peanut, soy, and wheat, performed from 2008-14, at a children's hospital's allergy clinics, were reviewed. OFCs were offered based on history and laboratory values. Reasons for food avoidance were classified as food allergy (IgE-mediated reaction occurring within two hours); sensitization only (lack of introduction due to positive test results); and removal due to test results during AD evaluation. RESULTS There were 442 OFCs performed, with 89 failures (20.1%). Reasons for OFCs included a history of food allergy (320/442; 72.4%); food sensitization without any introduction (77/442; 17.4%); and AD (45/442; 10.2%). OFC failures among those who had food allergy (70/320; 21.9%); sensitization only (13/77; 16.9%); and suspected AD trigger (6/45; 13.3%) did not significantly differ (p=0.63). Wheat was more likely to be avoided than the other four foods for AD concerns (p<0.0001). CONCLUSION The frequency of OFC failure among those who removed foods suspected as AD triggers was 13.3%, indicating a loss of tolerance. Restriction of foods to manage AD must be done with caution and close monitoring.
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    Variations in pollen counts between Indianapolis, IN, and Dayton, OH, in spring 2013 and 2014
    (Elsevier, 2016-09) Vitalpur, Girish; Padgett, Shaylar; Kloepfer, Kirsten M.; Slaven, James; Leickly, Frederick E.; Department of Pediatrics, IU School of Medicine