Joanne N.G. Oude Elberink

Bio: Joanne N.G. Oude Elberink is an academic researcher from University Medical Center Groningen. The author has contributed to research in topics: Systemic mastocytosis & Anaphylaxis. The author has an hindex of 18, co-authored 29 publications receiving 1335 citations. Previous affiliations of Joanne N.G. Oude Elberink include University of Groningen.

IgE-mediated food allergy diagnosis: Current status and new perspectives

Abstract: In June 2005, the work of the EU Integrated Project EuroPrevall was started. EuroPrevall is the largest research project on food allergy ever performed in Europe. Major aims of the project are to generate for the first time reliable data on the prevalence of food allergies across Europe and on the natural course of food allergy development in infants. Improvement of in vitro diagnosis of food allergies is another important aim of the project. The present review summarizes current knowledge about the clinical presentation of food allergy and critically reviews available diagnostic tools at the beginning of the project period. A major problem in diagnosis is a relatively poor 'clinical specificity', i. e. both positive skin tests and in vitro tests for specific IgE are frequent in sensitized subjects without food allergy symptoms. So far, no in vitro test reliably predicts clinical food allergy. EuroPrevall aims at improving the predictive value of such tests by proceeding from diagnosis based on allergen extracts to purified allergen molecules, taking into account the affinity of the IgE-allergen interaction, and evaluating the potential of biological in vitro tests such as histamine release tests or basophil activation tests including assays performed with permanently growing cell lines.

Fatal anaphylaxis after a yellow jacket sting, despite venom immunotherapy, in two patients with mastocytosis

Abstract: Death after a yellow jacket sting in otherwise healthy individuals receiving adequate immediate therapy is an u n c o m m o n occurrence. ~ Mastocytosis is overrepresented in patients first seen with anaphylaxis after insect stings, but it remains a rare disorder, even in this patient g roup2 This report describes two patients seen at our center with confirmed mastocytosis who died after a yellow jacket field sting, despite optimal treatment. Mastocytosis may be a risk factor for a severe or fatal reaction after Hymenop te ra stings in some patients with this disease.

Development and validation of the self-administered Food Allergy Quality of Life Questionnaire for adolescents

Abstract: Background Food allergy can affect health-related quality of life (HRQL). Currently, no validated, self-administered, disease-specific HRQL questionnaire for adolescents with food allergy exists. Objective We sought to develop and validate the Food Allergy Quality of Life Questionnaire–Teenager Form (FAQLQ-TF) in the Dutch language. Methods Ten adolescents (13-17 years) with food allergy were interviewed and generated 166 HRQL items. The most important items were identified by 51 adolescents with food allergy by using the clinical impact method, resulting in the FAQLQ-TF containing 28 items (score range: 1 "no impairment" to 7 "maximal impairment"). The FAQLQ-TF, the Food Allergy Independent Measure, and a generic HRQL questionnaire (CHQ-CF87) were sent to 98 adolescents with food allergy for cross-sectional validation of the FAQLQ-TF. Results Construct validity was assessed based on the correlation between the FAQLQ-TF and the Food Allergy Independent Measure (ρ = 0.57, P 2 food allergies: total FAQLQ-TF score, 4.3 vs 3.5; P = 0.037) but did not discriminate between those who did or did not have reported anaphylaxis. The FAQLQ-TF correlated weakly with 6 of the 11 CHQ-CF87 scales, demonstrating convergent/discriminant validity. Conclusion The FAQLQ-TF is the first self-administered, disease-specific HRQL questionnaire for adolescents with food allergy. It has good construct validity and excellent internal consistency and discriminates between adolescents who differ in the number of food allergies. The FAQLQ-TF is short and easy to use and might therefore be a useful tool in clinical research.

Venom immunotherapy improves health-related quality of life in patients allergic to yellow jacket venom

Abstract: Background: Venom immunotherapy (VIT) is effective in preventing anaphylactic reactions after insect stings. The effect of VIT on health-related quality of life (HRQL) was studied to evaluate whether this treatment is of importance to patients. Objective: We compared HRQL outcomes measured with a disease-specific instrument (Vespid Allergy Quality-of-Life Questionnaire [VQLQ]) in patients allergic to yellow jacket venom treated with VIT or with an adrenalin self-administration device (EpiPen) in an open-label, randomized, controlled trial. Methods: Consenting patients were block randomized to either VIT or EpiPen. Patients received uniform, standardized information, which specified the risk of their condition and the risks and benefits of both treatment options. HRQL measures took place before and after 1 year of treatment with VIT or EpiPen. Results: Seventy-four patients agreed to be randomized, of whom 36 received VIT and 38 an EpiPen. The mean change in VQLQ score in the group randomized to VIT was 1.07 (95% CI, 0.68-1.46), and this improvement was statistically significant ( P Conclusions: VIT results in a clinically important improvement in HRQL in patients allergic to yellow jacket venom in all subgroups studied. Of every 3 patients treated with VIT, 2 patients experience an important improvement in their quality of life. (J Allergy Clin Immunol 2002;110:174-82.)

Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy

Abstract: Background: The effects of an anaphylactic reaction after a yellow jacket sting on health-related quality of life (HRQL) have not been studied and are thus unknown. Objective: Development of a disease-specific instrument to measure HRQL in patients with yellow jacket allergy and validation of this instrument both cross-sectionally and longitudinally. Methods: Quality-of-life items were generated from patient interviews. Items with the highest impact were considered and correlated cross-sectionally with an independent measure (consisting of 2 questions in which patients were asked what they expected would happen if they were stung again, "Expectation of Outcome" questionnaire). Cross-sectional and longitudinal validation was achieved by administering this instrument to 69 Dutch patients. The questionnaire was also administered to 50 patients with yellow jacket allergy in Baltimore, Maryland, to establish cross-sectional validity of the English version. Results: The survey showed that patients experienced impairment in quality of life especially because of emotional distress. The resultant questionnaire has 14 items. The cross-sectional validation yielded a correlation coefficient of 0.69 for the Dutch version and 0.56 for the English version. The longitudinal validation yielded a correlation coefficient of 0.71. The responsiveness of this instrument was demonstrated by the questionnaire's ability to detect changes over time. It may be completed in approximately 10 minutes by patients without assistance. Conclusion: Patients with yellow jacket allergy experience impairment in quality of life especially because of emotional distress. It has been possible to develop and validate a questionnaire (the Vespid Allergy Quality of Life Questionnaire) by which the HRQL of these patients can be measured. The instrument may be administered rapidly and is easy to use. (J Allergy Clin Immunol 2002;109:162-70.)

The prevalence of food allergy: a meta-analysis.

Abstract: Background There is uncertainty about the prevalence of food allergy in communities. Objective To assess the prevalence of food allergy by performing a meta-analysis according to the method of assessment used. Methods The foods assessed were cow's milk, hen's egg, peanut, fish, shellfish, and an overall estimate of food allergy. We summarized the information in 5 categories: self-reported symptoms, specific IgE positive, specific skin prick test positive, symptoms combined with sensitization, and food challenge studies. We systematically searched MEDLINE and EMBASE for publications since 1990. The meta-analysis included only original studies. They were stratified by age groups: infant/preschool, school children, and adults. Results A total of 934 articles were identified, but only 51 were considered appropriate for inclusion. The prevalence of self-reported food allergy was very high compared with objective measures. There was marked heterogeneity between studies regardless of type of assessment or food item considered, and in most analyses this persisted after age stratification. Self-reported prevalence of food allergy varied from 1.2% to 17% for milk, 0.2% to 7% for egg, 0% to 2% for peanuts and fish, 0% to 10% for shellfish, and 3% to 35% for any food. Conclusion There is a marked heterogeneity in the prevalence of food allergy that could be a result of differences in study design or methodology, or differences between populations. Clinical implications We recommend that measurements be made by using standardized methods, if possible food challenge. We need to be cautious in estimates of prevalence based only on self-reported food allergy.

Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology

Abstract: Anaphylaxis is a clinical emergency, and all healthcare professionals should be familiar with its recognition and acute and ongoing management. These guidelines have been prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Taskforce on Anaphylaxis. They aim to provide evidence-based recommendations for the recognition, risk factor assessment, and the management of patients who are at risk of, are experiencing, or have experienced anaphylaxis. While the primary audience is allergists, these guidelines are also relevant to all other healthcare professionals. The development of these guidelines has been underpinned by two systematic reviews of the literature, both on the epidemiology and on clinical management of anaphylaxis. Anaphylaxis is a potentially life-threatening condition whose clinical diagnosis is based on recognition of a constellation of presenting features. First-line treatment for anaphylaxis is intramuscular adrenaline. Useful second-line interventions may include removing the trigger where possible, calling for help, correct positioning of the patient, high-flow oxygen, intravenous fluids, inhaled short-acting bronchodilators, and nebulized adrenaline. Discharge arrangements should involve an assessment of the risk of further reactions, a management plan with an anaphylaxis emergency action plan, and, where appropriate, prescribing an adrenaline auto-injector. If an adrenaline auto-injector is prescribed, education on when and how to use the device should be provided. Specialist follow-up is essential to investigate possible triggers, to perform a comprehensive risk assessment, and to prevent future episodes by developing personalized risk reduction strategies including, where possible, commencing allergen immunotherapy. Training for the patient and all caregivers is essential. There are still many gaps in the evidence base for anaphylaxis.

Standards and standardization in mastocytosis: consensus statements on diagnostics, treatment recommendations and response criteria.

Abstract: Although a classification for mastocytosis and diagnostic criteria are available, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and treatment responses. To address these demands, leading experts discussed current issues and standards in mastocytosis in a Working Conference. The present article provides the resulting outcome with consensus statements, which focus on the appropriate application of clinical and laboratory tests, patient selection for interventional therapy, and the selection of appropriate drugs. In addition, treatment response criteria for the various clinical conditions, disease-specific symptoms, and specific pathologies are provided. Resulting recommendations and algorithms should greatly facilitate the management of patients with mastocytosis in clinical practice, selection of patients for therapies, and the conduct of clinical trials.

The diagnosis and management of anaphylaxis practice parameter: 2010 update.

Abstract: These parameters were developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma and Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for establishing "The Diagnosis and Management of Anaphylaxis Practice Parameter: 2010 Update." This is a complete and comprehensive document at the current time. The medical environment is a changing environment, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, the ACAAI, or the Joint Council of Allergy, Asthma and Immunology. These parameters are not designed for use by pharmaceutical companies in drug promotion.