Clinical Cases  ·  Allergy and Immunology Vol. II  ·  Food & Drug Allergy
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Allergy and Immunology

Food & Drug Allergy

14 cases on peanut and multi-food oral immunotherapy, early peanut introduction and the NIAID addendum, sustained-unresponsiveness testing, cross-reactive pollen-food syndrome, alpha-gal syndrome and cetuximab cross-reactivity, FPIES resolution testing, penicillin allergy delabeling, unverified perioperative drug-allergy labels, severe cutaneous drug reactions and anticonvulsant cross-reactivity, radiocontrast premedication versus agent switching, aspirin/NSAID desensitization after PCI, epinephrine route selection, and biphasic-reaction prevention — choose a case below to open its full multi-voice debate.

Allergy and ImmunologyFood & Drug Allergy
Peanut Allergy: Starting Oral Immunotherapy After a Cafeteria Exposure

A boy's rising peanut-specific IgE and a recent anaphylaxis test whether oral immunotherapy or continued avoidance is the safer path forward.

Case 0001
Allergy and ImmunologyFood & Drug Allergy
Multiple Food Allergies: Omalizumab Alone or Alongside Oral Immunotherapy

A teenager with three food allergies and a family that already ruled out running three separate immunotherapy schedules considers a newly approved biologic instead.

Case 0002
Allergy and ImmunologyFood & Drug Allergy
Severe Infant Eczema and a Sibling's Allergy: Testing Before Peanut, or Waiting Too Long

A 5-month-old's severe eczema and an older sibling's near-fatal peanut allergy set guideline-recommended testing against how long an allergy referral actually takes.

Case 0003
Allergy and ImmunologyFood & Drug Allergy
Three Years Into Peanut Immunotherapy: Testing Whether the Tolerance Will Hold

A teenager who has never had a reaction on maintenance dosing raises the question of stopping — but the trial that actually tested discontinuation found most patients don't stay protected.

Case 0004
Allergy and ImmunologyFood & Drug Allergy
Birch Pollen and a Hazelnut Reaction: How Far the Avoidance Should Extend

Fifteen years of mild oral itching and one systemic reaction leave a woman's cross-reactive food list split between what her component testing clears and what it can't.

Case 0005
Allergy and ImmunologyFood & Drug Allergy
Alpha-Gal Syndrome and a Cancer Drug That Shares Its Target

A tick-bite-acquired red meat allergy runs directly into a chemotherapy antibody that carries the same carbohydrate the patient is already sensitized to.

Case 0006
Allergy and ImmunologyFood & Drug Allergy
Milk-Induced FPIES: Deciding Whether Two Is Old Enough to Find Out

A toddler's undetectable milk-specific IgE makes her a favorable candidate for a resolution challenge — but her family's fear and her narrowing diet are pulling the timeline in opposite directions.

Case 0007
Allergy and ImmunologyFood & Drug Allergy
A Childhood Penicillin Rash and an Infection That Won't Wait for Skin Testing

A validated risk score and a rising creatinine push a hospitalized man's decades-old penicillin label toward a same-day oral challenge instead of the traditional skin-test-first pathway.

Case 0008
Allergy and ImmunologyFood & Drug Allergy
Unverified Drug Allergy Labels Before Surgery: Test Them or Work Around Them

One patient has six weeks to sort out three unverified allergy labels before surgery; another has hours, a documented severe reaction, and no time left to test anything.

Case 0009
Allergy and ImmunologyFood & Drug Allergy
Uncontrolled Seizures and a Drug Reaction That Closed Off the Best Option

A DRESS reaction to carbamazepine has left a man's seizures poorly controlled — and every anticonvulsant that would work best for his seizure type shares a chemical family with the drug that nearly killed him.

Case 0010
Allergy and ImmunologyFood & Drug Allergy
A Contrast Reaction and a Cancer Scan the Staging Timeline Can't Skip

A moderate contrast reaction five years ago meets a new lymphoma diagnosis that needs contrast-enhanced imaging now — and premedication and agent selection turn out not to answer the same question.

Case 0011
Allergy and ImmunologyFood & Drug Allergy
A Fresh Stent, a Guideline That Needs Aspirin, and a History That Argues Against It

A man with a new drug-eluting stent needs guideline-standard dual antiplatelet therapy — but his history of NSAID-induced hives puts aspirin itself in question, and a newer trial complicates what the alternative even is.

Case 0012
Allergy and ImmunologyFood & Drug Allergy
Needle Phobia and a Nut Allergy: Choosing the Epinephrine He'll Actually Use

Two anaphylactic reactions were delayed by minutes that mattered — not by lack of medication, but by a needle fear no amount of training has fixed.

Case 0013
Allergy and ImmunologyFood & Drug Allergy
After the Epinephrine Works: Whether a Steroid Actually Prevents the Second Reaction

Standard practice has long added a steroid before discharge after anaphylaxis — but the evidence behind it, and the drug's own timing, don't line up the way the practice assumes.

Case 0014
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