HANE (HAE) 

HANE (HAE) 

A recent New England Journal of Medicine had three articles and an editorial about hereditary angioedema previously called hereditary angioneurotic edema.    By way of reminder, HAE causes recurrent episodes of swelling that can affect various parts of the body:  face, tongue, throat, abdomen, extremities.  It is caused by a gene mutation in SERPING 1 which controls the production of C1-inhibitor.  In type 1 HAE there is a deficiency of the inhibitor, in type 2 the inhibitor protein is present but…

Read More Read More

Chronic Pruritis 

Chronic Pruritis 

A recent issue of JAMA the Journal of the American Medical Association had a review article of this condition.    Chronic pruritis is defined as an itch that lasts 6 weeks or longer.  It occurs in 22% of people during their lifetime and it accounts for 1% of doctor visits in the US.  Chronic pruritis can be classified as either inflammatory or neuropathic.    The inflammatory causes are myriad.  Believe it or not a very common cause of inflammatory itch is dry…

Read More Read More

Dear Dr. K; 

Dear Dr. K; 

I’ve modified my diet to include lots of anti-oxidants and I take vitamin E, vitamin A and beta carotene supplements.  Now I’ve recently heard they don’t reduce inflammation.  What’s the truth and, oh by the way, why can’t scientists get things straight?  Well, first of all, scientists are people and therefore fallible.  But, science itself can be thought of as a ratchet to the truth moving forward one cog at a time.  And the complete truth/understanding may not become apparent…

Read More Read More

Immune Memory Cells 

Immune Memory Cells 

Scientists at McMaster University in Canada and at Mount Sanai in the US have co-discovered the cells that remember an allergy.  The Canadians call it MBC2 while the Americans call it a type 2 Memory B cell.    B cell refers to a type of lymphocyte critical to immune function.  B cells are the factory for producing immune proteins called immunoglobulins (Ig’s).  Ig’s have a finite life span, but the B cells are much longer lived.  This is important in terms…

Read More Read More

Islet Cell Transplant 

Islet Cell Transplant 

The FDA has recently approved the first pancreatic islet cell transplant for some type I diabetics.  By way of clarification, type I diabetes is due to loss of the pancreatic islet cells and therefore a lack of insulin.  Whereas; type II diabetes is due to insulin resistance because the islet cells are over producing insulin due to obesity.    Most type I diabetics can be treated with insulin, either by injection or continuous infusion.  But in a small minority safe control…

Read More Read More

Immune & Nervous Systems Interact 

Immune & Nervous Systems Interact 

Twenty years ago, if someone had said that the nervous system and the immune system interfaced with one another I probably would have scoffed.  I would have done so because with that era’s science I would have found it hard to conceive how brain and nerve cells could control individual immune cells and protein molecules and vice versa.  Boy, I would have been very wrong.  With the sophisticated molecular biology developed over the past five years or so scientists have…

Read More Read More

Dear Dr. K; 

Dear Dr. K; 

I’ve lived in Florida my whole life and had tons of mosquito bites, but now they are swelling way more and lasting a week or longer.  What’s up with that?  It means it’s time for you to leave Florida and lessen our traffic jams….no, just kidding.  Most likely it means you have developed an allergy, but a rare cause for strong reactions to arthropod bites is as an early sign of leukemia or myeloma.    Mosquitos have been around for over…

Read More Read More

Dear Dr. K;

Dear Dr. K;

I recently underwent food allergy testing at the behest of my gastroenterologist to see if food allergies are causing or contributing to my irritable bowel syndrome.  It turns out I’m allergic to five foods.  My question is how do I determine if all five are causing my symptoms or just one or two? That is a great question.  The guidelines I’m going to share with you were worked out in clinical research units.  In these settings patients are kept in…

Read More Read More

Omalizumab for Food Allergies

Omalizumab for Food Allergies

The FDA recently approved omalizumab (Xolair) to treat patients with food allergy including children as young as one year.  The approval came from several research trials including one recently published in the New England Journal of Medicine (NEJM) that was conducted at John’s Hopkins.  This particular study looked at allergy to peanut, cashew, egg, milk, walnut, hazelnut and wheat.  In the case of peanut allergy 67% of the test patients were able to consume 600 mg of peanut (equivalent to…

Read More Read More

That’s Bananas!

That’s Bananas!

By:  Sasha Klemawesch, MD If I asked you to tell me one fact about bananas, you’d probably cite how rich they are in Potassium.  And you wouldn’t be wrong. But, in addition to having approximately 10% of your daily value for potassium, they also contain about 10% of your daily needs for Magnesium, Vitamin C and Fiber.  While potassium is great for lowering blood pressure, maintaining muscle (including heart muscle) strength, and avoiding certain types of kidney stones, foods with…

Read More Read More