Wednesday, November 15, 2017

Expert Food Allergy Care Transforms Girl's World

Reese Robledo didn’t get to ride the school bus like other kids when she started first grade. Her parents feared the simple rite of passage might be far too dangerous because of their daughter’s life-threatening food allergies.

Photo of Reese Robledo as a baby
When Reese was a baby, her parents attributed her constant crying to eczema and possibly colic.

Reese, now 8, suffers from multiple life-threatening food allergies, including milk, eggs, wheat, peanuts, tree nuts, chicken, turkey, flax seed, mustard, barley, rye and kiwi. Just touching them can trigger hives, sneezing and itchiness. Accidentally ingesting one might result in anaphylaxis, the most severe form of allergic reaction that can cause difficulty breathing, vomiting, a drop in blood pressure, and though rare, even death.

Food allergies occur when the immune system recognizes the proteins in what are typically harmless foods as dangerous. This response causes the release of histamine and other chemical mediators that produce the physical symptoms of an allergic reaction.

Gold Standard for Diagnosis

Seeking care and advice, Reese’s parents turned to the Food Allergy Center at MassGeneral Hospital for Children (MGHfC).

Photo of Wayne Shreffler, MD, PhD
Wayne Shreffler, MD, PhD

The Food Allergy Center is breaking new ground in clinical care and research. As Reese’s family learned, its most important services include food challenges — the gold standard for diagnosing food allergies. To prevent the over diagnosis of allergies that often occur with blood and skin tests, patients are brought into a clinical setting and given small, increasing amounts of food that are suspected allergens. Patients are then monitored to determine whether they can tolerate the food.

“The core mission of the Food Allergy Center is to marry excellence in clinical care with opportunities to learn through research,” explains Wayne Shreffler, MD, PhD, the center’s director. “I am optimistic that if we can unlock the puzzle of what distinguishes a person’s immune system to allow them to outgrow allergies, we can apply that knowledge to gain more effective interventions.”

Seeking Food Allergy Triggers

Food allergies affect up to eight percent of children and four percent of adults – more than 15 million people in the U.S. alone. The only current treatment is avoidance.

Determining precisely which foods trigger reactions in individual patients is the first step in care.

Reese was a fussy baby, but her first-time parents, Mareesa and Rob, blamed her constant crying on eczema and possibly colic. At four months, Mareesa gave Reese her first bottle of cow’s milk formula. Within minutes, hives broke out on Reese’s mouth, neck and chest. “Wherever the milk had dribbled down, there were hives,” Mareesa recalls. “That was the first time I knew this was more than colic.”

The Robledos made an appointment with Qian Yuan, MD, pediatric gastroenterologist at MGHfC.

Skin Test Reactions

Reese’s reaction during the skin tests that ensued was when Mareesa and Rob realized the impact her allergies would have on their family, which also includes Reese’s 7-year-old brother Mack. “They poked her arm up and down with small doses of each food and her arm lit up with hives,” Rob says. “It was eye opening.”

Under Dr. Yuan’s guidance, the Robledos began to work with Dr. Shreffler and Lisa Stieb, RN, to learn how to keep Reese safe and ensure she received the nutrition necessary to grow and thrive.

Photo of Qian Yuan, MD
Qian Yuan, MD

The center also works with the Robledos and other families to help young patients maintain a high quality of life. “We don’t want food allergies to be a limitation of Reese’s life, or for her to be defined as a food allergy child,” Dr. Yuan says. “We all have medical limitations, but that’s not who we are.”

For a time, the Robledos considered home schooling for Reese, but with the help of the Food Allergy Center, Mareesa worked with teachers, nurses and administrators at Reese’s school in Hopkinton, Mass., to implement a plan that would ensure her safety in the classroom. The Robledos provided allergy-free snacks for Reese’s preschool class, and now in third grade, Reese sits at a nut and dairy-aware table at lunch.

A World of Difference

Meanwhile, Reese has completed more than a dozen food challenges. They have allowed for the addition of 12 key foods into her diet, including oat, beef and peas. “Peas are something you wouldn’t think are a big deal, but have been life changing for us,” Mareesa explains. “It has opened up cheese and protein-based pastas.

“Without the MGHfC team being able to do food challenges safely,” she adds, “it would be a different world.”

While Mareesa and Rob worry about how Reese will manage her allergies as an adolescent, they hope Food Allergy Center research will lead to better treatment options. To that end, Reese is participating in a clinical trial being conducted by the center to hopefully build her tolerance against one of her allergens.

First Bus Ride Home

Photo of Reese Robledo
Doctors say Reese has bloomed into an articulate child who feels empowered to manage her own food allergies.

For the Food Allergy Center staff, it has been a pleasure to witness the strides Reese has made. “She’s bloomed into a poised, articulate child who is a good advocate for herself and really feels empowered to manage her disease,” Dr. Shreffler reflects. “It’s very gratifying that she’s thriving, maintaining composure, and doing activities an 8-year-old girl should do,” adds Dr. Yuan.

The patient herself seems to be taking each day in stride. “My allergies don’t stop me from doing anything,” Reese says proudly, following her first-ever bus ride home from school.

For more information about how you can support the Food Allergy Center’s research into new treatments, please contact us.

Back to Top