Patient Care - Allergy & Immunology - October 2007 - (Page 5)

MEDICINE in the News Dear Doctor, Patient Care is pleased present topics in allergy and immunology for primary care physicians. This issue covers common and uncommon conditions in primary care: celiac disease, angioedema, and allergic rhinitis. Celiac disease is now known to be one of the most common immune-mediated disorders that primary care doctors have an important role in identifying and treating. Authors Gavin F. Chico, MD, and Michelle A. Chico, MD, advise that a high degree of suspicion can lead to proper testing and implementation of a lifesaving diet. Turn to page 6 for their article, “When to suspect celiac disease—and how to proceed from there.” Our cover article, “Averting angioedema’s potentially dire consequences” (page 13), discusses the management of an uncommon but potentially life-threatening spectrum of conditions. Authors Borislav Stoev, DO, and Michael A. Bohrn, MD, emphasize early diagnosis and timely treatment. “Is there a role for leukotriene receptor antagonists in treating allergic rhinitis?” (page 19) covers a condition that affects millions of Americans, many in your waiting room today. The article by Michael Kaliner, MD, reviews the different mechanisms by which current therapies modulate allergic rhinitis and evaluates the clinical evidence for their use. For more topics in primary care, please go to www.patientcareonline.com to subscribe free to the digital editions of Patient Care. John J. Russell, MD Medical Editor Managing anaphylaxis in the ED: A SAFE approach naphylaxis is a serious, potentially lethal allergic reaction that prompts tens of thousands of emergency department (ED) visits a year. Yet a review of the literature demonstrates the inadequacy of the treatment that many of these patients receive in the ED. Management tends to rely on antihistamines rather than epinephrine injection—despite widespread recognition that the latter should be first-line treatment for this emergency condition—and neglects essential patient education on how to handle future episodes. To rectify this situation, the American College of Allergy, Asthma, and Immunology (ACAAI) and the American College of Emergency Physicians convened an A S A F E eek Support: Instruct the patient about the risk of future episodes and the need to seek care at the first sign of another reaction. llergen identification and Avoidance: Question the patient about events immediately preceding the reaction to help identify triggers and avoid them in the future. ollow-up for specialty care: Advise the patient to seek a referral for consultation with an allergist for testing, diagnosis, and ongoing management of the allergy. pinephrine for Emergencies: Provide a prescription for a self-injectable epinephrine kit, explain how to use it, and emphasize the importance of carrying the pen at all times and of making family and friends aware of the risk of anaphylaxis and showing them how to use the pen. Continued on page 18 OCTOBER 2007 PATIENT CARE ALLERGY & IMMUNOLOGY 5 http://www.patientcareonline.com

Table of Contents Feed for the Digital Edition of Patient Care - Allergy & Immunology - October 2007

Patient Care - Allergy & Immunology - October 2007 Research Digest Contents Medicine in the News When to Suspect Celiac Disease and How to Proceed From There Averting Angioedema’s Potentially Dire Consequences Is There a Role for Leukotriene Receptor Antagonists in Treating Allergic rhinitis? Clinical Clips Dermatology Case Challenge Classified Advertising

Patient Care - Allergy & Immunology - October 2007

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