Download - ÜRTİKER ve GIDALAR
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ÜRTİKERve
GIDALAR
Prof.Dr. Mustafa ŞENOLEmekli Öğretim Üyesi
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Isırgan Otu (Urtica Dioica, Urtica Urens)
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Gıdaların Yan Etkileri
Nonimmünolojik (Gıda İntoleransı)
Metabolik
Farmakolojik
Toksik
Diğer
J Am Diet Assoc 2011;111:1877-91.
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Gıda İntoleransı
Vazoaktif aminler (Tiramin, Histamin…)(Peynir, Alkol, Balık, Salam-Sosis, Konserve)
Farmakolojik ajanlar (Histamin salgılatanlar) (Yumurta, Deniz ürünleri, Çilek, Domates, Çikolata, Meyve suları)
Gıda katkıları(Asetil salisilat, Sülfitler, Azo boyaları, Tartrazin, Benzoik asit…)
SKINmed 2006;5:119-25.
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YORK Testi ???
Int Arch Allergy Immunol 2011;155 (1):52-6.
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Gıdaların Yan Etkileri İmmünolojik (Gıda Allerjisi)
IgE-bağımlı
IgE-bağımlı olmayan
Mikst mekanizmalar
Hücresel
Ürtiker-Anjioödem
Anafilaksi
Atopik Dermatit
Kontakt Dermatit
SKINmed 2006;5:119-25.
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Gıda Allerjisi
Çocuk Yumurta, İnek sütü, Fıstık, Diğer yağlı çerezler, Balık, Soya
Erişkin Fıstık, Diğer yağlı çerezler, Balık, Deniz ürünleri
SKINmed 2006;5:119-25.
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Akut ürtiker-Anjioödem
İnsidans: ~%20 %20 olguda sebep gıdalar Çocuk
Yumurta, İnek sütü, Fıstık, Diğer yağlı çerezler, Balık, Soya, Diğer proteinler, Konserve, Gıda katkıları…
ErişkinFıstık, Diğer yağlı çerezler, Balık, Deniz ürünleri, Diğer
proteinler, Konserve, Gıda katkıları…
Ped Clin North Am 2011; 58(2):315-26.
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Kronik ürtiker-Anjioödem
Br J Dermatol 2012;166(4):747-52.
İnsidans: ~%0.5
Otoimmün: %45
İdyopatik: %55
Gıdalarla ilişki nadir
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Kontakt Ürtiker
Çayır
Hayvan tüy ve tozları
Gıdalar (Susam, buğday)
Lateks
Gıda katkıları
Ann Dermatol Venereol 2010: 137( 4): 281-4.
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Ekzersizle İndüklenen Anafilaksi(Nonspesifik-Spesifik)
Buğday Deniz ürünleri Domates Çilek Çerez Fıstık Peynir
J Am Diet Assoc 2011;111:1877-91.Int Arch Allergy Immunol 2002;129:19-26.
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Ürtikerde çok suçlanan gıdalar
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Gıda Katkı Maddeleri(~1000 adet)
1. Raf ömrünü uzatanlar (Koruyucular)
2. Hazırlama ve pişme özelliğini geliştirenler
3. Aroma ve renk geliştiriciler
4. Besin değerini geliştiriciler
Ind J Dermatol Venereol Leprol 2010:76(2):103-15.
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E Sistemi
Renklendiriciler Koruyucular Antioksidanlar Emülsifiyer-stabilizatörler Asit-baz sağlayıcılar Tatlandırıcılar-koku verenler Geniş amaçlı katkılar
E100-180 E200-297 E300-321 E322-500 E500-578 E620-637 E900-927
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Doğal katkı maddeleri
Sülfitler (Antioksidan-antimikrobiyal)
Monosodyum glutamat (E621, tatlandırıcı)
Tartrazin (E102, sarı boya)
TSK Koruyucu Hekimlik Bülteni, 2007: 6 (5):351-6.
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Yapay katkı maddeleri
Benzoatlar (Antimikrobiyal)
Parabenler (Antimikrobiyal)
Nitrit ve nitratlar (Antioksidan-antimikrobiyal)
Aspartam (Tatlandırıcı)
TSK Koruyucu Hekimlik Bülteni, 2007: 6 (5):351-6.
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Tanı Hikaye Fizik muayene Laboratuvar
Prik test (Özellikle çocuklarda)
Prik to prik test
Spesifik IgE Semptom günlüğü Eliminasyon diyetleri Provokasyon testleriJ Am Diet Assoc 2011;111:1877-91.
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Prik test
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Prik to prik test
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Spesifik IgE testi (RAST)
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Provokasyon testi
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Tedavi
Şüpheli gıdadan uzak durmak Antihistaminikler (Oral-parenteral) Kortikosteroidler (Oral-parenteral) Adrenalin (im) Bronkodilatörler (Sprey-iv) TNF-alfa blokörleri ? Lökotrien antagonistleri ?
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Tedavi
Oral desensitizasyon Plazmid DNA immünizasyon Probiyotikler (Laktobasillus)
Allerjen immünoterapi (Denatüre
listeria monositogenes ile) → TNF-ɑ artışı
Çin bitkileri
Intern Emerg Med 2009;4:11-24.
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Özet Genetik Gıdalar-katkı maddeleri İlaçlar İklim Stres Enfeksiyon Otonom-kolinerjik sistem Genel sağlık Menstruasyon Ekzersiz ……Bütüncül Yaklaşım !!!
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Malatya’dan
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Teşekkürler !