Telemedicine in Oral Immunotherapy for food allergy
Keywords:
Food allergy, oral immunotherapy, Telemedicine, COVID-19Abstract
Background: Food allergy is defined as an abnormal immune response to food allergens. Food oral immunotherapy (OIT) is a promising treatment for persistent and severe food allergies. OIT consists of daily ingestion of increasing doses of the allergen during the build-up phase, and ingestion of a constant dose during the maintenance phase. In build-up phase involves increasing the food allergen doses every 2-4 weeks at the allergy clinic to observe allergic reaction and monitor vital signs for 2 hours after ingestion. Due to the coronavirus disease 2019 (COVID-19) situation, updosing during the build-up phase or follow-up during the maintenance phase was very challenging clinicians from facing significant limitations of service. Many patients had to postpone the appointment, consequently, they were unable to up-dose at the hospital as regular schedule. Therefore, we had applied a telemedicine system into our practice with food allergy patients.
Objective: The purpose of this report is to provide information regarding the treatment of two patients with food allergies using oral immunotherapy via telemedicine
Case report: A Thai girl of 5 years old was diagnosed with wheat anaphylaxis, and a boy of 5 years old was diagnosed with cow milk protein allergy and treated with oral immunotherapy. As a result, a COVID-19 outbreak occurred. Consequently, we were unable to make appointments for patients to increase their food intake at the hospital. Telemedicine has been used in the treatment of patients with food allergies, allowing them to increase their dosages to maintenance levels.
Conclusion: Telemedicine is the delivery of real-time healthcare services via digital communication technologies remotely rather than face-to-face encounters between a patient and a provider. Therefore, the treatment can continue and allows the patient to increase the amount of food to the maintenance dose without unnecessary delayed. Telemedicine is also convenient for patients in terms of commute, time saving and infection risk reduction which is the concerning issue for this era.
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