Table Of ContentALLERGIC DISEASES
CURRENT CLINICAL PRACTICE
0 0
Allergic Diseases: Diagnosis and Treatment,
edited by PHIL LIEBERMAN AND JOHN A. ANDERSON, 1997
Osteoporosis: Diagnostic and Therapeutic Principles,
edited by CLIFFORD J. ROSEN, 1996
ALlERGIC DISFASES
DIAGNOSIS AND TREATMENT
Edited by
PHIL LIEBERMAN, MD
Allergy Associates, Cordova, TN
and
JOHN A. ANDERSON, MD
Henry Ford Health System, Detroit, MI
*-
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
© 1997 Springer Science+Business Media New York
Originally pubhshed by Humana Press Inc. in 1997
Softcover reprint oftbe hardcover 1st edition 1997
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Library of Congress Cataloging-in-Publication Data
Allergic diseases: diagnosis and treatment/edited by Phil Lieberman and John A. Anderson
p. cm.---(Current clinical practice)
Includes index.
ISBN 978-1-4757-2593-3 ISBN 978-1-4757-2591-9 (eBook)
DOl 10.1007/978-1-4757-2591-9
1. Allergy. I. Lieberman, Phil 1. II. Anderson, John A. (John Albert), 1935-. III. Series.
[DNLM: 1. Hypersensitivity-diagnosis. 2. Hypersensitivity-therapy. WD 300 A43108 1997]
RC584.A343 1997
616.97-dc20
DNLM/DLC
for Library of Congress 96-38857
CIP
PREFACE
We have experienced, in our over 60 years of combined teaching and practice of
allergy and immunology, most of the challenges that our field can present. We felt it
desirable to share this experience with other physicians engaged in the care oft he allergic
patient. In order to do that we assembled a group of authors who we felt were extremely
knowledgeable in given areas of allergy immunology and have asked them to share this
knowledge with our readers. We presume that these readers will be physicians engaged
in the "front line" care of the allergic patient. We have thus attempted to make this
textbook as "user friendly" and clinical as possible.
The text is designed to give an overview of the principles of pathophysiology in such
a manner as to allow them to be applied to the therapy ofthe patient. The major intent of
the volume, however, is to help the physician deal with the day-to-day approach to the
allergic patient.
The text is arranged to deal with individual disease states as well as the tools that we
use to treat the allergic patient. Thus, there are chapters on common allergic diseases,
such as asthma and rhinitis, as well as sections devoted to the drugs used to manage
allergic patients and special techniques, such as allergen immunotherapy and environ
mental control.
In addition, controversial areas in our field are dealt with in a separate chapter written
to familiarize the nonspecialist with forms of therapy that are, at best, of questionable
value, and at worst no value at all. It is our hope that the text will disseminate some oft he
practical knowledge that we have accumulated over our three decades of practice and
teaching. We also hope that its message has been delivered effectively, mainly to the
primary care physician who is involved with the care of allergy patients.
Phil Lieberman, MD
John A. Anderson, MD
v
To Barbara
p.L.
and
To Nicole
J.A. A.
CONTENTS
Preface ...................................................................................................... v
Contributors .............................................................................................. ix
1 Allergic Disease: Pathophysiology and Immunopathology ............. 1
Randy 1. Horwitz and Robert F. Lemanske, Jr.
2 Approach to the Allergic Patient .................................................... 15
Michael S. Blaiss
3 Diagnostic Tests in Allergy ............................................................ 27
Dennis R. Ownby
4 Environmental Allergens ................................................................ 37
Scott H. Sicherer and Peyton A. Eggleston
5 Anaphylaxis ..................................................................................... 47
Phil Lieberman
6 Insect Sting Allergy ........................................................................ 65
Robert E. Reisman
7 Evaluation and Treatment of the Child with Asthma .................... 77
Gail G. Shapiro, C. Warren Bierman, and Frank S. Virant
8 Asthma in Adults .......................................................................... 105
Randy 1. Horwitz and William W. Busse
9 Rhinitis .......................................................................................... 131
Phil Lieberman
10 Sinusitis and Otitis Media ............................................................. 151
Jonathan Corren, Jerome Thompson, and Gary S. Rachelefsy
11 Diagnosis and Treatment of Allergic Diseases of the Eye .......... 161
Kari Blaho and Stephen Winbery
12 Urticaria and Angioedema ............................................................ 189
Dennis K. Ledford
13 Atopic Dermatitis .......................................................................... 205
Stacie M. Jones and A. Wesley Burks, Jr.
14 Contact Dermatitis and Other Contact Reactions ........................ 233
Jere D. Guin
15 Food Allergy and Intolerance ....................................................... 255
John A. Anderson
16 Allergic and Allergic-Like Reactions to Drugs
and Other Therapeutic Agents .................................................. 275
John A. Anderson
vii
viii Contents
17 f3-Adrenergic Agonists .................................................................. 293
Clifton T. Furukawa
18 Theophylline ................................................................................. 301
Elliot F. Ellis
19 Nonsteroidal Anti-Inflammatory Drugs for the Treatment
of Asthma and Allergic Disease ............................................... 315
Phil Lieberman
20 Anticholinergic Agents ................................................................. 323
Phil Lieberman
21 Glucocorticoid Therapy in Asthma .............................................. 331
Joseph D. Spahn, Alan K. Kamada, and Stanley J. Szejler
22 Environmental Control for Allergic Disease ................................ 351
Edward M. Zoratti
23 Allergen Immunotherapy .............................................................. 363
Roger W Fox and Richard F. Lockey
24 Controversies in Allergy and Allergy-Like Diseases .................. 377
Abba 1. Terr
Index ...................................................................................................... 387
CONTRIBUTORS
JOHN A. ANDERSON, MD • Divisions ofP ediatrics and Internal Medicine, Henry Ford
Health System, Detroit, MI
C. WARREN BIERMAN, MD • Northwest Asthma and Allergy Center, Seattle, WA
KARl BLAHO, PHD • Department of Emergency Medicine, UT Medical Group,
Memphis, TN
MICHAEL S. BLAISS, MD • Department of Medicine, University of Tennessee,
Memphis, TN
A. WESLEY BURKS, JR., MD • Department ofP ediatrics, University ofA rkansas for
Medical Sciences, Arkansas Children's Hospital, Little Rock, AR
WILLIAM W. BUSSE, MD • Section ofA llergy and Clinical Immunology, Clincal
Science Center, University of Wisconsin Hospital and Clinics, Madison, WI
JONATHAN CORREN, MD • Department ofM edicine, School ofM edicine, University of
California, Los Angeles, CA
PEYTON A. EGGLESTON, MD • Division ofA llergy and Immunology, Department of
Pediatrics, Johns Hopkins Hospital, Baltimore, MD
ELLIOT F. ELLIS, MD· Muro Pharmaceuticals, Tewksbury, MA
ROGER W. Fox, MD • University of South Florida, C/O VA Medical Center, Tampa,
FL
CLIFTON T. FURUKAWA, MD • Northwest Asthma and Allergy Center, Seattle, WA
JERE D. GUIN, MD • McLellan VA Hospital; Department ofD ermatology, University
ofA rkansas Medical Center, Little Rock, AR
RANDY 1. HORWITZ, MD, PHD • Section ofA llergy and Clinical Immunology,
Department ofM edicine, University of Wisconsin, Madison, WI
STACIE M. JONES, MD • Department of Pediatrics, University ofA rkansas for Medical
Sciences, Arkansas Children's Hospital, Little Rock, AR
ALAN K. KAMADA, PHARMD • Division of Clinical Pharmacology, Ira J. and
Jacqueline Neimark Laboratory of Clinical Pharmacology in Pediatrics, Denver,
CO; Department of Pharmacy Practice, School ofP harmacy, University of
Colorado Health Sciences Center, Denver, CO
DENNIS K. LEDFORD, MD • Division ofA llergy and Clinical Immunology, Department
ofI nternal Medicine, VA Medical Center, College ofM edicine, University ofS outh
Florida, Tampa, FL
ROBERT F. LEMANSKE, JR., MD • Pediatric Allergy Section, University of Wisconsin
Hospital, Madison, WI
PHIL LIEBERMAN, MD • Departments ofM edicine and Pediatrics, Division ofA llergy
Immunology, University of Tennessee College ofM edicine, Memphis, TN;
Section ofA llergy-Immunology, Baptist Memorial Hospital, Memphis, TN
RICHARD F. LOCKEY, MD • University ofS outh Florida, C/O VA Medical Center,
Tampa, FL
DENNIS R. OWNBY, MD • Division ofA llergy and Clinical Immunology, Department of
Pediatrics, Henry Ford Health System, Detroit, MI
ix
x Contributors
DENNIS R. OWNBY, MD· Division ofA llergy and Clinical Immunology, Department of
Pediatrics, Henry Ford Health System, Detroit, MI
GARY S. RACHELEFSKY, MD • Department ofP ediatrics, School ofM edicine,
University of California, Los Angeles, CA
ROBERT E. REISMAN, MD • Department ofM edicine and Pediatrics, School of
Medicine, State University ofN ew York at Buffalo, NY; Buffalo Medical Group,
Williamsville, NY
GAIL G. SHAPIRO, MD • Northwest Asthma and Allergy Center, Seattle, WA
SCOTT H. SICHERER, MD • Division ofA llergy and Immunology, Department of
Pediatrics, Johns Hopkins University School ofM edicine, Baltimore, MD
JOSEPH D. SPAHN, MD • Divisions of Clinical Pharmacology and A llergy-Clinical
Immunology, Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology
in Pediatrics, Denver, CO; Department ofP ediatrics, National Center for
Immunology and Respiratory Medicine, Denver, CO; Department ofP ediatrics,
School ofM edicine, University of Colorado Health Sciences Center, Denver, CO
STANLEY J. SZEFLER, MD • Divisions of Clinical Pharmacology and Allergy-Clinical
Immunology, Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology
in Pediatrics, Denver, CO; Departments ofP ediatrics and Pharmacology,
National Center for Immunology and Respiratory Medicine, Denver, CO;
Department ofP ediatrics, School ofM edicine, University of Colorado Health
Sciences Center, Denver, CO
ABBA I. TERR, MD· Department ofA llergy and Immunology, School ofM edicine,
Stanford University, San Francisco, CA
JEROME THOMPSON, MD· Department of Otolaryngology and Pediatrics, School of
Medicine, University of Tennessee, Memphis, TN
FRANK S. VIRANT, MD • Northwest Asthma and Allergy Center, Seattle, WA
STEPHEN WINBERY, PHD, MD • Department ofE mergency Medicine, UT Medical
Group, Memphis, TN
EDWARD M. ZORATTI, MD· Division ofA llergy and Clinical Immunology, Henry Ford
Hospital, Detroit, MI
