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Immunologist Chantilly, VA

Posted by Black & Kletz Allergy on February 9, 2015

Black & Kletz Allergy offers the services of a full time immunologist Chantilly, VA residents respect, who serves the population in the greater Washington, DC, Northern Virginia, and Maryland metropolitan area. Our allergy and immunology practice has the following 3 office locations: Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.

Our immunologist Chantilly, VA inhabitants trust, is a specialist physician trained and experienced in diagnosing and treating the disorders of the immune system. Our immune system exists to protect us from infections and cancers. It defends us against infections from various germs (e.g., viruses, bacteria, fungi, parasites). Our immunologist Chantilly, VA residents admire, can accurately diagnose various disorders of the immune system and offer effective treatments in order to improve the quality of life of individuals with these immune disorders.

The immune system can be defective either from birth (i.e., primary immune deficiency conditions) or the immune function can deteriorate later in life due to various organic diseases (i.e., secondary immune deficiency disorders). Our immunologist Chantilly, VA inhabitants have confidence in, may perform various tests to differentiate these conditions from one another so that appropriate treatments can be offered.

Primary immune deficiency disorders may lead to an increase in the frequency and severity of infections. This tendency can begin either in infancy or later in life depending on the specific type of disorder and its severity. These infections can take the form of frequent respiratory (i.e., ears, nose, throat, sinuses, lungs), gastrointestinal, skin and soft tissue, and/or urinary tract infections. Infections such as otitis media (i.e., middle ear infection, recurrent strep infections of the throat, sinusitis, bronchitis, pneumonia, skin boils, and recurrent urinary tract infections are just some of the infections that are prevalent in individuals with an immunodeficiency. It is important to note that some of the immune disorders may also present with skin disorders such as eczematous rashes.

The evaluation for these conditions by our immunologist Chantilly, VA residents respect begins with a comprehensive history taken by our immunologist. Our immunologist will delve into the nature, frequency, and severity of such infections. After a thorough history is taken, it is followed by a detailed physical examination. The diagnosis will be confirmed by the immunologist Chantilly, VA inhabitants trust after performing specific laboratory tests. These tests may involve the determination of the numbers and functions of certain types of white blood cells known as lymphocytes.

Some types of lymphocytes (i.e., B lymphocytes or B cells) are responsible for producing antibodies (i.e., immune globulins) as an immune defense and other types of lymphocytes (i.e., T lymphocytes or T cells) are instrumental in the type of defense known as cell-mediated immunity. It is possible that either or both types of immune defenses can be defective. Our immunologist Chantilly, VA residents respect will evaluate for many different types of disorders before finally establishing the diagnosis. Our immunologist Chantilly, VA residents admire will also test for the responses to immunizations that the patients received during their childhood. Individuals with immune deficiencies will not be able to mount adequate responses to vaccinations.

One example of an immunodeficiency is the condition known as common variable immunodeficiency. Common variable immunodeficiency is one of the most common primary immune deficiencies, even though the prevalence is about 1 in every 50,000 individuals. In this condition, either the number or the function of the lymphocytes is defective. As a result, protective antibodies are not manufactured in sufficient numbers, which predisposes the patient to more frequent and severe infections.

Individuals with immune deficiencies are usually treated by our immunologist Chantilly, VA inhabitants trust with regular antibody replacements. The process of antibody replacement involves infusions of commercially available pooled antibodies every 1 to 4 weeks. These immunodeficiencies usually need long-term continuous treatments in order to prevent recurrent infections.

Another way that the immune system can malfunction is by turning against its own organs or tissues. This phenomenon is called autoimmunity. Essentially, one’s immune system sees its own body as “foreign” and as result, attacks its own organs and/or body tissues. Clinical manifestations vary widely depending on the organs involved. These autoimmune disorders are also evaluated and co-managed by our immunologist Chantilly, VA residents respect, typically along with a Rheumatologist.

The allergists at Black & Kletz Allergy treat both pediatric and adult patients. We have 3 offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All of our office locations have on-site parking. The Washington, DC and McLean, VA offices are Metro accessible and the McLean, VA office has a free shuttle that runs between our office and the Spring Hill metro station on the silver line. You may also click Request an Appointment and we will respond within 24 hours by the next business day. Black & Kletz Allergy has been a fixture in the greater Washington, DC, Northern Virginia, and Maryland metropolitan area for over 50 years for our exceptional services for the diagnosis and treatment of allergies, asthma, and immunological disorders.

Pediatric Allergist Ashburn, VA

Posted by Black & Kletz Allergy on January 27, 2015

Black & Kletz Allergy practice offers the services of a full time pediatric allergist Ashburn, VA inhabitants respect. Our pediatric allergists underwent several years of specialized training in the diagnosis and treatment of all types of allergic and immunological disorders affecting children, as well as adults. They also have decades of experience in managing these disorders as they have treated thousands of children and young adults.

Our pediatric allergist Ashburn, VA residents trust evaluates and treats, among other things, environmental, food, insect sting, and medication allergies. Inhalant allergens or aeroallergens typically affect the upper and lower respiratory tract and eyes. Food allergens can affect the gastrointestinal tract, skin (i.e., eczema, hives), and rarely multiple systems in a condition known as anaphylaxis (i.e., acute severe life-threatening reaction). Anaphylaxis as well as skin symptoms can also be caused by medication allergies such as penicillin, sulfa, aspirin, ibuprofen, etc.

When aeroallergens affect the eyes, the condition is called allergic conjunctivitis. The conjunctivae are the thin transparent membranes that covers the front side of the eyeballs. When the conjunctivae are exposed to the aeroallergens that the child has previously been sensitized to, these membranes become inflamed. Due to increased blood flow, the eyes turn red and excessive tears are produced. The eyes also itch, sometimes uncontrollably. Our pediatric allergist Ashburn, VA residents admire begins his evaluation by obtaining a comprehensive history of the frequency and severity of the specific symptoms, with special attention to their seasonal variation, if any. The next step would be prick skin testing or a blood testing in order to identify the specific allergen triggers. After the diagnosis is established, our pediatric allergist Ashburn, VA inhabitants trust provides detailed information about the various ways of avoiding exposure to the offending allergens. When avoidance is not practical or feasible, our board certified allergist will usually prescribe medications in order to alleviate the bothersome symptoms that arise from allergies. These medications may include oral medications, nasal sprays, eye drops, and/or topical skin medications.

When inhalant allergens affect the upper respiratory tract, the condition is termed allergic rhinitis, which indicates inflammation of the mucus membrane lining of the inside of the nose and throat. After performing a comprehensive history, our pediatric allergist Ashburn, VA residents respect will usually perform diagnostic skin and/or blood tests, as appropriate. The symptoms of allergic rhinitis (i.e., hay fever) may include nasal congestion (i.e., due to inflammatory swelling of the tissues called turbinates which are located inside the nostrils), runny nose (i.e., due to excessive secretion of mucus), post-nasal drip (i.e., due to excessive drainage of mucus down the back of the throat), and itching of the nose and/or throat. In addition to information about environmental control, the pediatric allergist Ashburn, VA inhabitants admire will prescribe medications I order to provide relief from the annoying symptoms of allergies. These again may include include oral medications, nasal sprays, eye drops, and/or topical skin medications.

When the environmental controls and medications do not adequately control the symptoms, the pediatric allergist Ashburn, VA residents trust can offer a long term treatment option called allergen immunotherapy. This modality entails exposing the immune system to gradually increasing doses of allergen extracts in small increments at regular intervals in a standardized protocol. This process is very effective in building tolerance to the allergens that the child is sensitized to. This process helps in preventing the symptoms and reducing the need for medications in the long term.

When the inhalant allergens affect the lower respiratory tract, inflammation of the tissues inside the lungs may result in the symptoms of asthma. These can consist of coughing, chest tightness, wheezing, and difficulty in breathing. The pediatric allergist Ashburn, VA residents admire at Black & Kletz Allergy has over 30 years of experience in treating children with asthma. Our allergist will identify the relevant allergens by allergy testing and will provide detailed information to children and their parents as to how to avoid exposure to them. Many children with asthma need inhaled medications in order to adequately control their asthma. There are daily maintenance medications to control the inflammation, prevent the symptoms, reduce exacerbations, and preserve the lung function. The pediatric allergist Ashburn, VA residents trust will give detailed information to the patients and their families regarding various medication options including the benefits and risks with each as well as help choose the most appropriate medication in a shared decision making process. In addition to providing prescriptions, the pediatric allergist Ashburn, VA inhabitants respect will explain and demonstrate the proper technique of using the various inhaler devices, which could consist of metered dose aerosols and dry powder inhalers. The pediatric allergist Ashburn, VA residents trust will also coach the parents to properly monitor their child’s symptoms and lung function parameters.

The other conditions treated by pediatric allergist Ashburn, VA residents admire include hives or urticarial (i.e., itchy red blotches and welts of various sizes and shapes on the skin) and eczema or atopic dermatitis (i.e., dry, flaky, itchy and sometimes excoriated skin patches over face, trunk and extremities). Allergic sensitivity to certain foods can play a role in these disorders. The pediatric allergist Ashburn, VA residents trust offers testing to detect the offending foods and teaches children and their parents about ways of avoiding exposure to them. Unfortunately, desensitization options are not available for most foods (except peanuts) and avoidance of exposure is the only option in its management. Epinephrine auto-injectors are prescribed by the pediatric allergist Ashburn, VA residents admire for children at risk for anaphylaxis and our allergist will demonstrate the proper technique of using these devices. Note that if an epinephrine auto-injector is ever used, it is very important to then go immediately to the closest emergency room.

The board certified pediatric allergists at Black & Kletz Allergy have been diagnosing and treating children and adults in the Washington, DC metropolitan area for more than 50 years. We have 3 convenient locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area. We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA which all offer on-site parking. The Washington, DC and McLean, VA locations are Metro accessible and there is a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. Please call us to make an appointment or you can click Request an Appointment and we will reply within 24 hours by the next business day. The pediatric allergy specialists of Black & Kletz Allergy are eager to help you with your allergy, asthma, sinus, and immunology needs. We are dedicated to providing excellent care and service to you and your family.

Allergist Northern VA

Posted by Black & Kletz Allergy on January 26, 2015

Black & Kletz Allergy has an allergist northern VA resident’s trust on its staff for more than 30 years. The allergist northern VA of Black & Kletz Allergy has on its staff is board certified in allergy and clinical immunology with decades of experience in treating both allergic and immunological disorders. Some of the conditions treated and managed by the allergist northern VA inhabitants believe in are seasonal and year-round respiratory allergies caused by environmental and aeroallergens, food allergies, medication allergies, skin allergies, insect venom allergies, chemical sensitivities, asthma, eczema, and immunodeficiencies.

Aeroallergen or environmental allergen sensitivity leads to a condition commonly known as hay fever, which is technically called allergic rhinitis which can be seasonal or perennial in nature. Our allergist northern VA residents admire will identify the specific allergens that each patient is sensitized to by performing relevant allergy tests. The results will enable our allergist to recommend relevant environmental control measures which would minimize one’s exposure to the triggering agents and thus lessen the suffering of the affected individuals. Some of the mostly indoor allergens playing a role in causing hay fever symptoms may include dust mites, mold spores, animal dander, and cockroaches. Outdoor allergens may include pollens from trees, grasses, and weeds. Note that molds are both indoor and outdoor allergens.

Black & Kletz Allergy’s allergist northern VA resident’s trust is trained in performing and interpreting allergy skin and blood tests to accurately identify the triggers in an individual patient and diagnose the conditions based on a comprehensive history and physical examination complemented by allergy test results. Our allergist northern VA inhabitant’s respect is also experienced in providing the necessary education to patients and the most appropriate ways of managing their condition. The management options considered and offered to the patient by our allergist northern VA appreciate may include various medications as well as allergy desensitization. Medications may help to relieve allergy symptoms and make the patient more comfortable. Two examples of medications used in the treatment of allergies include antihistamines in order to help relieve itching, sneezing, runny nose, and watery eyes, as well as nasal sprays which are used to help control nasal congestion, runny nose, and post nasal drip.

It should be noted that in general, medications only mask the symptoms of allergies and do not treat the underlying cause of allergic disorder. Our allergist northern VA inhabitant’s trust has special expertise in treatment modalities called immune therapies (i.e., immunotherapy) which alter the underlying mechanism of allergy and build up tolerance to the allergens, so that symptoms can be prevented instead of being masked. These desensitization therapies have been in use for more than 100 years. During the process of desensitization, the allergist northern VA residents admire identifies the relevant specific allergic antigens for an individual and makes a serum of these antigens which will be administered by injections under the skin at regular intervals with gradually increasing concentrations and volumes. This systematic exposure to the allergens helps the immune system develop tolerance to these allergens. This process is akin to vaccinations against infectious agents such as viruses and bacteria which effectively prevents serious diseases subsequently when natural exposure to these microbes occurs.

The process of desensitization can have 2 main side effects. The allergist northern VA resident’s respect is trained and experienced in detecting these adverse reactions very early and to treat them expeditiously. The more common side effects are local reactions at the site of injections in the form of local itching, redness, and/or a small to moderate sized local swelling. These reactions can begin after a few hours and can last a few days. They can be managed with the local application of ice, using an over-the-counter corticosteroid cream, and/or taking an anti-inflammatory medication such as ibuprofen to help relieve any discomfort.

Very rarely, there can be a generalized or systemic reaction after an allergy injection which could be more dangerous. The allergist northern VA resident’s praise monitors patients after the injections very closely in order to detect it early. Black & Kletz Allergy’s allergist northern VA inhabitant’s respect has the special training and expertise needed to treat these adverse reactions and to arrest their progress, if they should happen to occur.

The board certified allergy specialists at Black & Kletz Allergy have 3 convenient locations with on-site parking located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. The Washington, DC and McLean, VA offices are Metro accessible and we offer a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. The allergy doctors at Black & Kletz Allergy are extremely knowledgeable regarding allergies and other related conditions such as asthma, eczema, sinus problems, hives, swelling episodes, generalized itching, eosinophilic esophagitis, and immune disorders. We diagnose and treat both adult and pediatric patients. To schedule an appointment, please call any of our offices or you may alternatively click Request an Appointment and we will respond within 24 hours by the next business day. We have been servicing the Washington, DC, Northern Virginia, and Maryland metropolitan area for more than 50 years and we look forward to providing you with comprehensive allergy care in a professional and cordial environment.

Cockroach Allergies

Posted by Black & Kletz Allergy on January 19, 2015

It is an awful thought, but many people are allergic to cockroaches. No one likes to think that they are within miles of a cockroach, however, cockroach allergy is one of the most common indoor pests. They can cause many problems for those allergic to them including allergic rhinitis symptoms (sneezing, runny nose, nasal congestion, etc.), asthma symptoms (wheezing, shortness of breath, chest tightness, and/or cough), and skin symptoms (itching and/or rash). There is a very strong correlation between chronic asthma and cockroach allergy. Since cockroaches live in homes and businesses throughout the year, patients suffering from cockroach allergy have year-round symptoms. Other allergens such as dust mites, mold, and pets can also cause perennial symptoms and must also be assessed when diagnosing an allergy or asthma patient for year-round symptoms. In addition to causing allergies and asthma, cockroaches can also carry and transmit various diseases.

Cockroaches live just about everywhere and have adapted to living in all types of climates. There are over 3,500 species and they have been around for more than 300 million years. In general, cockroaches are nocturnal and are usually not seen during the daylight hours. Since cockroaches prefer moist and warmer environments, they tend to gather more in kitchens, bathrooms, basements, cracks in the walls, and closets. In the U.S., the two most common species are the German (Blattella germanica) and American (Periplaneta Americana) cockroaches. They tend to be much more common in the inner cities. Thus, cockroach allergies are fairly prevalent in people living in inner cities. Anywhere between 30 – 60% of asthmatics living in an urban area are said to be allergic to cockroaches. Overall, about 33% of the U.S. population are sensitive to cockroaches, if they are allergic to at least one other allergen such as dust mite, mold, pollen, pets, etc.

In inner-city children with asthma, the percentage of cockroach sensitivity increases to between 55 – 80%. Most urban locations, including Washington, DC, have their fair share of cockroaches living amongst us. It is estimated that over 75% of urban homes and/or apartments have cockroaches present. Even more shocking is that the number of cockroaches living in each home or apartment ranges from about 1,000 to over 300,000 insects. For every cockroach you see, there are approximately 800 present that you don’t see.

The cause of cockroach allergy Is due cockroach allergens. These allergens are found in the saliva, feces, and exoskeleton of the insect. The most common cockroach allergens are Bla g 1, Bla g 2, and Per a 1. Other cockroach allergens include Bla g 4, Bla g 5, Bla g 6, Bla g 7, Bla g 8, Bla g 9, Per a 2, Per a 3, Per a 4, Per a 5, Per a 6, Per a 7, Per a 8, Per a 9, and Per a 10.

One can be diagnosed with cockroach allergy by seeing an allergist who would then take a careful history from the patient. After an examination, the allergist would test the patient for cockroach allergy by either skin or blood testing.

The treatment of cockroach allergy first involves prevention of further contact with cockroaches. This is easier said than done. It is very difficult to get rid of every cockroach in a home, but there are some things that should be tried which include: keep garbage and food in closed containers; make sure that there are no leaky pipes or faucets; do not leave dirty dishes in the sink or on kitchen countertops; do not bring food into the bedrooms; make sure to close up any holes in the walls or baseboards to decrease entry and exit paths for cockroaches; contact an exterminator for help with cockroach infestation. In addition to prevention, there are a multitude of medications that can be used to help relieve the allergy, asthma, and/or skin symptoms that one can experience from their cockroach sensitivity. They come in various formulations including pills, syrups, nasal sprays, inhalers, and creams. Allergy shots (allergy immunotherapy) are a very effective means to treat cockroach allergy and are used in both children and adults.

The board certified allergists at Black & Kletz Allergy have managed thousands of patients with cockroach allergy for more than half a century in the Washington, DC, Northern Virginia, and Maryland metropolitan area. We have 3 convenient locations with offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. Our Washington, DC and McLean VA locations are easily accessible by car or the Metro. We have parking at all 3 of our locations. Please call us or click Request an Appointment on our website to schedule an appointment, if you have any of the symptoms mentioned above. We look forward to diagnosing and treating you in order for you have a better quality of life.

Mammalian Meat Allergy

Posted by Black & Kletz Allergy on January 12, 2015

Mammalian Meat Allergy is a delayed allergic reaction triggered by eating the meat of some mammals. The condition was discovered by researchers at the University of Virginia only a few years ago. Their findings of this new allergy were published in 2009. The allergy initially was confined to the southeastern part of the U.S. with a majority of the cases in Virginia. Subsequently, the condition has become more widespread. Mammalian Meat Allergy is initiated by a bite from a Lone Star Tick (Amblyomma americanum), named because of its distinctive small white mark on its back. Many people deny a tick bite and instead say there were bitten by chiggers (a type of mite), even though chiggers do not cause the allergy. For this reason, it is prudent that an allergist ask the patient if they have ever been bitten by a tick or a chigger. In susceptible individuals, the bite sets off a chain reaction which results in the formation of an IgE antibody (the “allergy” antibody) that attaches to a carbohydrate (sugar) present in the meat of only mammals called galactose-alpha-1,3-galactose (also known as “alpha-gal”). This is present in mammalian meat such as beef (cow), pork (pig), lamb (sheep), venison (deer), rabbit, goat, bison, whale, etc. It is also important to point out that for people who travel to exotic locations, one must be aware that there are other mammals that are eaten which contain alpha-gal. Some of these mammals include horse, dog, cat, squirrel, guinea pig, kangaroo, and whale, to name a few. Since fish, shellfish, and poultry (i.e., chicken, turkey, duck, quail) are not mammals; they do not have alpha-gal.

In this condition, unlike a typical food allergy, the symptoms usually do not start for several hours (typically 3-6 hours) after the consumption of the offending meat from a mammal. In more common food allergies like peanut, tree nut, fish, and shellfish allergies, symptoms usually begin in less than one hour after exposure to the food. When a person who harbors this antibody eats the meat from mammals, it causes release of histamine and other chemicals which are responsible for allergic reactions. The symptoms can include itching, rashes, hives, swellings of lips, tongue and other soft tissues, abdominal pain, nausea, vomiting, and diarrhea. In severe instances, it can also lead to life threatening anaphylactic reactions resulting in difficulty in breathing, drop in blood pressure, dizziness, and loss of consciousness. In summary, the person will develop delayed anaphylaxis, angioedema (swelling), and/or urticaria (hives).

If you have experienced any of the above symptoms, please call Black & Kletz Allergy and request to see one of our board certified allergists at any one of our 3 locations in Northern Virginia and Washington, DC. We can confirm or rule out the condition by taking a complete history, performing an examination, and obtaining a blood sample. Avoiding meat from mammals and in severe cases limiting the intake of dairy products can prevent serious and dangerous adverse reactions.

The “Cold” of Winter Has Effect on Allergy and Asthma Patients

Posted by Black & Kletz Allergy on December 15, 2014

The onset of winter in the Washington DC metro area has brought two cold-related health problems to the forefront.

The first one concerns many people with respiratory disorders like asthma and COPD (Chronic Obstructive Pulmonary Disease). Cold dry air is a known irritant to the respiratory passages and can trigger an increase in the frequency and severity of respiratory symptoms like coughing, wheezing, and shortness of breath. In addition, respiratory infections, especially caused by viruses, are more prevalent during the winter months. Influenza (the “flu”) is just one of the many viral infections which are notorious in aggravating asthma and pulmonary-related conditions.

Avoiding exposure to the cold air, in addition to minimizing the chance of developing a viral upper respiratory tract infection by frequent hand washing and covering one’s sneezes and coughs, can help prevent flare-ups in people with breathing difficulties such as asthma and COPD. People with persistent asthma (defined by any asthma symptom which occurs more often than twice a week during the daytime and/or more often than twice a month during the nighttime) need to use their controller medications on a daily basis as prescribed, in order to reduce the chances of exacerbating their asthma. Controller medications may include inhaled corticosteroids, long-acting beta agonists, leukotriene antagonists, and/or theophylline. In more severe asthmatics that meet certain criteria, a humanized antibody called Xolair (omalizumab), may also be prescribed in order to help prevent asthma exacerbations.

The second issue concerns people with a history of a specific type of “hives” called “cold-induced urticaria.” Though there are usually multiple triggers for hives (urticaria), exposure to colder temperatures can result in giant hives over exposed skin in susceptible individuals. The condition can be very serious in selected patients and is usually diagnosed in our office by an “ice cube test,” where an ice cube is placed on the forearm of the patient for 10 to 15 minutes and then removed. When the skin re-warms in a few minutes, an elevated red wheal or hive in the shape of the ice cube confirms this disorder. In rare instances, this condition is also associated with some systemic diseases and blood tests for cold agglutinins and cryoglobulins may be appropriate. Treatment begins with avoiding the cold when possible. In addition, various medications can be used to help prevent the hives and/or anaphylaxis that can occur in people with this condition.

The board certified allergists at Black and Kletz Allergy are experts in cold-related respiratory and skin disorders. Please call any one of our 3 office locations in Washington, DC, McLean, VA (Tysons Corner, VA) or Manassas, VA if you need further information or are in need of an evaluation and advice regarding any of the cold-related disorders above or other cold-related disorder not mentioned above.

Asthma in the Winter

Posted by Black & Kletz Allergy on November 20, 2014

With the onset of cold weather, some children and adults with a history of asthma are experiencing flare-up of their symptoms. Breathing in cold, dry air can irritate and inflame the lungs, causing acute exacerbations of one’s asthma. The other common triggers of asthma symptoms are viral infections, which are usually more common in winter months.

The viral infections usually begin as “cold-like” symptoms with sneezing, followed by copious amounts of clear mucus in one’s nasal secretions and usually are associated with nasal congestion. Some of us also can have a skin rash, low-grade fever, sore throat, and/or frequent cough. Many children and adults recover spontaneously from these infections after a few days. However, they can result in aggravation of asthma, causing the typical symptoms of wheezing, chest tightness, coughing and/or difficulty in breathing.

A few precautions during the coming season may ward off flare-ups of asthma, the suffering, and the loss of productive time:

Avoid exposure to the cold air to the extent possible. Wearing a face mask while walking outdoors during the height of winter can be helpful.

The air can be very dry indoors and can irritate the respiratory passages. A room humidifier will help in hydration of the air we breathe.

General hygiene, frequent hand-washing, avoidance of sharing utensils, etc. may prevent certain infections.

Staying home when sick and covering the sneezes and coughs can keep the infections from spreading.

Plenty of fluids, rest, and eating well will help in a faster recovery.

Antibiotics usually have no role in viral illness, except in rare secondary bacterial infections.

Receiving the influenza vaccination (flu shot) as soon as possible in the season.

Pneumococcal vaccine, as per indications.

Children and adults with a history of frequent flare-ups of asthma during the late fall or early winter should begin taking the daily controller medications on a regular basis starting early in the season. At times, one also may need to increase the doses of preventive maintenance medications.

The board certified allergists and staff at Black and Kletz Allergy practice are always available to answer questions and address the concerns of people in the greater Washington, DC, Northern Virginia, and Maryland metropolitan area who may be dealing with above conditions. Feel free to contact us by phone or via our “Request an Appointment” page on our main website to make an appointment.

SINUS INFECTION vs. “COLD” vs. WINTER ALLERGIES vs. FLU

Posted by Black & Kletz Allergy on November 12, 2014

As Winter approaches, people with dust, mold, and pet allergies tend to suffer more than those with pollen allergies. Pollen levels in the mid-Atlantic region (Washington, DC, Virginia, Maryland, etc.) become immeasurable once the first frost occurs. The first frost usually occurs by November in our region of the country. Therefore, when people experience the typical allergy symptoms during the late Fall and Winter months, dust mites and/or molds are generally the culprits. Keep in mind that there are other causes of these symptoms, namely the common cold, flu (influenza), or other upper respiratory tract infection (i.e., sinus infection, bronchitis). How does one know the difference between winter allergies, a “cold,” the “flu” or other type of upper respiratory tract infection?

WHAT ARE THE SYMPTOMS?

Winter Allergies – the same symptoms as seasonal allergies and can include all or some of the following: runny nose, nasal congestion, post-nasal drip, sore throat, cough, sneezing, itchy nose, itchy eyes, watery eyes, red eyes, itchy throat, fatigue, sinus headaches, wheezing, and shortness of breath.

Common Cold – can include all or some of the above symptoms, but in addition may contain achiness, fever, and chills, although discolored nasal discharge and a fever do not occur in most cases of the common cold.

“Flu” (also referred to as influenza) – can include all or some of the symptoms of the common cold, but unlike a “cold,” there is usually severe achiness and/or headache, and a fever is almost always present.

Note: For the flu season of 2014-2015, one must be cognizant of the recent Ebola epidemic in Western Africa. If a person develops “flu-like” symptoms and has traveled to Western Africa and/or if they have been in contact with someone infected with the Ebola virus in the last 21 days, he or she must assume that they could have Ebola and should contact the CDC (Centers for Disease Control) and local county and state health agencies for guidance about seeking medical care at an appropriate hospital. If one cannot get in touch with the CDC or local health agency, they should go immediately to closest emergency room.

Sinus Infection (also referred to as sinusitis) – can include all or some of the symptoms of the common cold, but unlike a “cold,” there usually is discolored nasal discharge, sinus pain and/or pain that radiates to the teeth.

WHAT ARE THE CAUSES?

Winter Allergies – Dust mites; Molds: Pets; Cockroaches

Common Cold – Viruses ; Note that there are many more viruses that cause the common cold. “Flu” – Viruses (Influenza virus types A, B, and/or C)

Sinus Infection – Viruses, Bacteria, and/or Fungi (Most are caused by viruses)

HOW ARE THESE CONDITIONS DIAGNOSED? Besides a thorough history of your symptoms and a physical examination, the following also help our physicians distinguish between the 4 common conditions below:

Winter Allergies – An experienced allergist can perform blood and/or skin tests to evaluate if you have a true allergy to one of the many allergens that can cause winter allergy symptoms. When symptoms last longer than 1-2 weeks or there is a history of recurring symptoms every Winter or perennial (year-round) symptoms, allergies should be a top concern.

Common Cold – Typically the symptoms last less than 1 week in duration and resolve on their own.

“Flu” – A fever is the hallmark of this condition. The flu can be very serious particularly in the elderly. There are rapid influenza diagnostic tests that can identify the flu in about 30 minutes. These require that the physician to wipe the inside of the back of one’s throat or nose with a swab and then send it for testing. They are not 100% accurate however.

Sinus Infection – The symptoms may begin as a result of an individual being exposed to an allergen, virus, and/or bacteria. A thorough history together with a complete examination of the ears, nose, mouth, and throat can usually identify a sinus infection in the majority of patients. Further diagnostic studies such as a CT scan of the sinuses may be necessary in some individuals. When there is recurrent sinus infections, the diagnosis of chronic sinusitis and/or an immunologic disorder should be investigated by an experienced allergist.

WHAT ARE THE TREATMENTS?

Winter Allergies – There are many allergy medications that can be used which include tablets, syrups, nasal sprays, and/or allergy shots (allergy immunotherapy or allergy injections).

Common Cold – Usually self-limited and generally does not require treatment except to help relieve symptoms with medications and nasal sprays.

“Flu” – Usually self-limited and generally does not require treatment except to help relieve symptoms with medications and nasal sprays. Occasionally a severe case or a case in the elderly may need hospital care of complications from the flu which can include dehydration, pneumonia, and other more severe complications. Antiviral flu medications can be taken to reduce the duration and severity of the flu. These medications work best if they are taken within the first 48 hours of the beginning of symptoms, however they can still be effective if taken later.

Sinus Infection – May need to be treated with antibiotics if it persists or is recurrent. Other medications may also be used if needed to help alleviate the symptoms with tablets, syrups, and/or nasal sprays.

WHAT CAN BE DONE TO PREVENT THESE CONDITIONS?

Winter Allergies – Avoidance of dust mites, molds, and pet exposure. Allergy medications and/or allergy shots (allergy immunotherapy or allergy injections).

Common Cold – Washing of hands; good hygiene; avoidance of crowded areas.

“Flu” – Flu vaccination (unless one has a reason not to take it such as egg allergy, previous reaction to the flu vaccine or the preservative used in the flu vaccine, etc.). In addition, one should avoid exposure to people with the flu. They should also practice good hygiene, avoid crowded areas during the flu season, wash their hands, etc.

Sinus Infection – Control allergies; washing of hands, good hygiene; avoidance of crowded areas.

As one can see from the information above, it may not be so easy for the average person to distinguish the difference between Winter allergies, the common cold, the flu, and a sinus infection. Many of the symptoms are the same, similar, and/or overlap. The board certified allergists at Black & Kletz Allergy have the expertise to help diagnose the correct ailment and more importantly, treat your problem. We have 3 office locations in the Washington, DC metro and Virginia areas and we will be happy to schedule a visit for you at your earliest convenience.

Pet Allergy: What You Should Know

Posted by Black & Kletz Allergy on October 9, 2014

The two most common pet allergies in the United States are cats (20% of the population) and dogs (10% of the population). Dogs, however, are the most common pet, followed by cats. There has been an upward trend in the U.S. in the number of household pets with almost 70% of households having at least one pet. Of course, besides dogs and cats, other common pets include birds, rodents (i.e., hamsters, guinea pigs, gerbils, chinchillas, mice, etc.) reptiles (i.e., lizards, snakes, turtles, etc.), rabbits, ferrets, horses, hermit crabs, spiders, and fish. Horses, unlike the other pets mentioned above, do not live in people’s homes, but can be quite allergenic.

One can be allergic to any animal, but clearly the most common indoor pet allergies are cats and dogs. For the purpose of this blog, we will talk exclusively about cats and dogs. If you would like to see more information about allergies to other types of pets, please visit our website, www.bkallergy.com , click “SERVICES,” and then click the 4th bullet which is a link entitled “Pet Allergies.”

When an individual is “allergic” to a pet, they are in fact “allergic” to particular proteins that are produced by that animal. For example, the proteins that cause most of the misery suffered by people who are allergic to cats are designated “Fel d 1” and “Fel d 4.” Likewise, in individuals that are allergic to dogs, the major protein involved is called “Can f 1.” Most proteins that cause allergies in any household pet tend to be concentrated in the pet’s dander, urine, saliva, and/or feces.

The dander (from the skin of an animal) tends to be a big problem with most pets. In cats, the dander tends to “stick” to things such as clothing, walls, carpeting, bedding, etc. and therefore can and is “transported” from the home to other places that people go to, such as their workplace. If Fel d 1 protein is measured on a cat owner’s clothing or their upholstered chair at work, it is likely to be found. In addition, since the proteins stick to the walls of the cat owner’s home, it takes months for the proteins responsible for causing an allergic reaction to diminish to non-detectible levels, despite a thorough cleaning of the home. Since the protein is also found in urine, cat litter boxes are a rich source of the proteins. In dogs, luckily the protein Can f 1 is not as “sticky” as the cat proteins, but still can stick to clothing, bedding, etc.

As a general rule, it is advisable not to have a pet if one is allergic to it. However, despite common sense, most people still opt to either acquire a pet or to keep an existing pet that they have had even if they cause bothersome allergy symptoms. Even though this is not advised, it is understandable since a pet can cause great joy in one’s life and becomes a member of the family!

One major misconception is that there are “hypoallergenic” cats and dogs. While some people feel that

they do better around short-haired cats or around dogs that do not shed like poodles, most scientific studies do not support this phenomena.

One can take some measures to reduce their exposure to the allergens that cause pet allergies. Brushing your cat or dog frequently and bathing your cat or dog often will help reduce the levels of cat and proteins. It is also advisable to prevent the cat or dog from entering your bedroom.

The symptoms of pet allergies are similar to any other type of environmental allergy. The symptoms can include any or all of the following: sneezing, runny nose, stuffy nose, itchy/watery/red puffy/eyes,

post-nasal drip, itchy skin, hives, wheezing, chest tightness, coughing, and/or shortness of breath.

The board certified allergists at Black and Kletz Allergy can help you diagnose whether you have a pet allergy by simple tests which involve a thorough history and physical examination as well as skin tests and/or blood tests. In addition to avoidance measures, there a number of medications that can be tried to try to alleviate your symptoms of pet allergies. These medications can be in the forms of tablets, nasal sprays, eye drops, creams, inhalers, and/or injections. Since pet allergies are a perennial (year-round) problem, many patients find allergy shots (allergy immunotherapy) extremely effective in preventing and/or diminishing their pet allergy symptoms. Allergy shots can be administered to children, pregnant women, and adults and have been used for over a century.

If you would like to have a consultation with us regarding your pet allergies (or other type of allergies), please call us or use our website to “Request An Appointment” and we will get back to you by the next work day. Black and Kletz Allergy has been serving the Washington, DC metropolitan area including Maryland and Northern Virginia for more than 50 years.

Mold Allergies

Posted by Black & Kletz Allergy on October 6, 2014

As the temperatures are dropping and the leaves are starting to “fall”, the ragweed and other weed pollen counts are also gradually decreasing, but the mold spores will be a significant trigger of asthma and allergy symptoms in the coming few months for sensitized individuals.

Mold is a fungus which can cause bothersome symptoms in a few different ways:

Allergic Reaction: Though all of us are exposed to molds, only some of us develop “sensitivity” to them determined by our genetic composition. When a genetically predisposed individual inhales spores from molds, his/her immune system considers them as foreign invaders and manufactures antibodies in an attempt to fight them. These antibodies memorize the particular spores and “attack” them when they are exposed to them again. This reaction causes certain chemicals like histamine to be released into the tissues which cause the typical symptoms of sneezing, stuffy/runny nose, itchy/watery eyes, etc. (Note: If your vision is seriously impaired, it may be a sign on something more severe, and you may wish to consult with a LASIK surgeon in Washington DC.)

Irritant Reaction: Molds can release substances called volatile organic compounds (VOC’s) which can irritate skin and mucus membranes inside the mouth, nose and eyes resulting in burning sensation, watery eyes, runny nose, scratchy throat and cough.

Toxic Reaction: Mycotoxins, produced by certain types of molds, in addition to causing irritant symptoms can also lead to flu-like symptoms, fatigue, headache, dizziness, and shortness of breath.

Infection: Though skin lesions are the most common infectious manifestation, different types of molds also can cause respiratory, gastrointestinal, and neurological disorders.

Molds are found in both indoor and outdoor environments and thrive in high humidity. Moist and decaying leaves on the ground, which tend to peak in the Fall, form a substrate for the mold growth. Damp basements, leaky faucets, wet shower curtains, and wet bathroom tiles also encourage proliferation of molds. Though many mold overgrowths are visible, their spores are microscopic and are air-borne. The most common types of molds that cause human suffering are alternaria, hormodendrum, cladosporium and penicillium.

Most people sensitive to mold spores only exhibit “hay fever”- like symptoms involving the eyes, nose, mouth, and throat. Less commonly, molds also play a role in more serious conditions like:

Allergic Asthma: In sensitized individuals with a history of asthma, mold spores can induce sudden and severe flare-ups of asthma symptoms which may require emergency treatments and/or cause an increase in the number or dose of controller medications.

Allergic Bronchopulmonary Aspergillosis (ABPA): It is a hypersensitive reaction to a particular type of mold called aspergillus in the lungs of patients with persistent asthma or cystic fibrosis.

Allergic Fungal Sinusitis: A chronic inflammatory response of the membranes and tissues inside the sinus cavities can be caused by certain types of molds in susceptible people.

Diagnosis: Mold allergies can be detected either by skin testing or by measuring the amount of specific IgE antibodies in a blood sample by a clinical laboratory. Skin testing is a more sensitive test and is the preferred method used by allergists. A detailed history of the symptoms and their possible triggers in the environment followed by a focused physical examination will help the allergist in determining the type of testing needed to confirm the diagnosis.

Treatment: The first principle in the management of any allergic disorder is to identify the possible triggering and aggravating factors in the environment and to avoid exposure to them to the extent possible. To reduce exposure to the mold spores, the following measures can be quite useful:

As dampness encourages mold growth, indoor humidity levels should be kept below 50 percent. Avoiding water leaks and running a dehumidifier in damp and musty areas of the house can also inhibit mold proliferation.

Installing HEPA filters in HVAC systems and changing them periodically will reduce indoor spore counts by trapping them before fresh air is circulated.

Adequate ventilation of the bathrooms either by running the exhaust fan or opening the windows will reduce mold growth. Keep in mind that by opening the windows, outdoor molds may enter one’s home which can be counterintuitive.

Proper care of indoor plants such as removing the dead leaves and avoiding standing water can be helpful.

Wearing a face mask to cover the nose and the mouth before raking leaves and cutting grass will reduce exposure to molds substantially.

Mold spore counts are usually higher at nights when the atmosphere is cool and damp. Closing the windows will keep the outdoor molds from entering inside one’s home.

Medications like ocular, nasal, and oral antihistamines as well as nasal and inhaled anti-inflammatory drugs can relieve the misery of symptoms to a certain extent. When environmental control measures and medications do not help enough or when the side effects of the drugs are bothersome, a desensitization process (i.e, allergy shots or allergy immunotherapy), which induces tolerance to the offending allergens, can be a long term solution which is highly efficacious.

The board certified physicians and staff at Black & Kletz Allergy have the training, expertise, and decades of experience in the diagnosis and treatment of adults and children with mold and other allergies in a professional, caring, and patient-friendly environment in the Washington, DC, Maryland, and Northern Virginia area.

Ragweed Allergies – What Are They and Do You Have Them?

Posted by Black & Kletz Allergy on September 2, 2014

As summer draws to a close and schools reopen across our region, most of us look forward to cooler days and fall colors. But if you are one of several million Americans who suffer from “Hay Fever” (“seasonal allergic rhinitis,” as it is more accurately named) to ragweed, the rising levels of pollen from ragweed are sure to increase your misery due to your allergic reaction to these pollen grains.

Though many weeds like Pigweed, Mugwort/Sagebrush, Cocklebur, and Russian thistle pollinate in the fall, Ragweed (species Ambrosia) is the most common and predominant allergen in our geographical area. Each plant can produce up to one billion pollen grains per season, and these can remain airborne for several days and travel hundreds of miles from the site of origin. In the Washington, DC metropolitan area, the ragweed pollen usually starts appearing in the air in mid-August. The pollen counts gradually increase and peak in early September and subside after the first frost which is usually in late October. Many scientists believe that rising temperatures and an increase in atmospheric carbon dioxide (CO2) levels may prolong the ragweed season.

When a person who has been previously sensitized to a particular pollen is exposed to that pollen in the air, the proteins trigger specialized cells in the immune system to release excessive levels of histamine and other chemical mediators which are responsible for various allergic symptoms, some of which are listed below:

Excessive sneezing
Itchy, red, puffy, watery eyes
Persistent runny nose
Nasal stuffiness, blockage, or congestion
Itchy throat and post-nasal drip leading to a dry cough
In asthmatic individuals, the pollen can also induce flare-ups of wheezing, chest tightness, cough and/or breathing difficulty.

In ragweed sensitive people, eating fresh fruits and vegetables like melons (cantaloupe, honeydew, watermelon, etc.), cucumber, zucchini, kiwi, and bananas may cause itching and tingling of mouth, tongue, and throat. This condition is called “pollen-food allergy syndrome” or “oral allergy syndrome” and is due to cross-reacting proteins in the pollen and fresh fruits.

A few avoidance measures can reduce the exposure to pollen and the suffering:

Minimize outdoor activities in the early morning hours when the pollen counts tend to be the highest.
Keep the windows at home and in automobiles closed and use air-conditioning.
Shower to remove pollen from the skin and hair after coming indoors and wash clothing.
Nasal irrigation can wash the pollen and irritants from nasal passages.

If the symptoms are bothersome, several medications like antihistamines (available in pills, liquid, nose sprays and eye drops), decongestants (pills and liquid), and corticosteroids (nasal sprays, pills, liquid), either alone or in combination may offer considerable relief. To be optimally effective, the medicines are best started a few days before the onset of the active season. For many people with moderate to severe sensitivity, allergy immunotherapy (also referred to as “allergy shots,” will cause a desensitization to that pollen, which in this case is ragweed pollen) will offer the most effective long-term relief from the symptoms and can reduce or eliminate the need for medications.

The physicians and Washington, DC allergy doctors at Black and Kletz Allergy practice in DC and northern Virginia have several decades of experience and expertise in managing ragweed sensitive patients and are committed to provide the most up to date and evidence based treatment options in a patient-friendly environment.

Food Allergy vs. Food Sensitivity (Food Intolerance) vs. Food Poisoning

Posted by Black & Kletz Allergy on August 28, 2014

Many people are convinced that they have food allergies. For some, this is a correct assumption. For others, they may actually have a food sensitivity or food intolerance, but not a true food allergy. Still others, may have an episode of food poisoning. In order for it to be a true food allergy, there must be a specific immune response to a particular food protein involving the immunoglobulin E (IgE) antibody (also known as the “allergy” antibody). This type of reaction is called a Type I, IgE-mediated immunologic reaction. The symptoms of a food allergy usually occur within seconds to a couple of hours after exposure to a food.

FOOD SENSITIVITY or FOOD INTOLERANCE:

A food sensitivity or food intolerance, on the other hand, is a non-immune toxic reaction against a food. Unlike food allergies, the reaction usually occurs in a delayed fashion and typically develops between 1 hour and 3 days after eating the food. It carries a much lower risk and is not as serious. The food can affect different people in different ways. Any organ system can be affected. Since it can take days to develop symptoms, people with food sensitivities are difficult to diagnose and may go undiagnosed for many years. One of the best ways to determine if someone has a food sensitivity is to do a food elimination diet and then add one food at a time back for several days to see if their symptoms re-occur. If it does, then the individual should remove that food from their diet. Some examples of food sensitivities and their cause are as follows:

Gluten Intolerance – Inability to digest gluten (wheat, rye, and/or barley) or more recent research suggests that it may be the inability to digest FODMAP’s (Fermentable Oligo-, Di-, Mono-saccharides and Polyols) rather than gluten.

Lactose Intolerance – Deficiency of the enzyme “lactase” which normally breaks down the sugar lactose found in milk products.

Favism (Glucose-6-phosphate dehydrogenase deficiency or G6PD deficiency) – Genetic deficiency in the enzyme G6PD causes anemia, fatigue, abdominal pain, headache, fever, etc. when these individuals eat fava beans or take certain medications (i.e., sulfonamides, certain anti-malarial drugs, aspirin, nitrofurantoin, dapsone, isoniazid).

Adverse Reactions to Preservatives and/or Food Dyes – Some examples include sulfites, tartrazine, sodium benzoate, nitrates, nitrites, parabens, monosodium glutamate (MSG), aspartame, and butylated hydroxytoluene (BHT).

Pharmacologic Effect of Food – Some examples of chemicals found in a variety of foods include caffeine, tyramine, and histamine.

FOOD POISONING:

Food poisoning can mimic the symptoms of food allergies or food sensitivities. Typically these symptoms of food poisoning can include diarrhea, abdominal pain, nausea, and/or vomiting. Other symptoms more consistent with food poisoning than that of either food allergies or food sensitivities include fever, bloody diarrhea, blood in vomit, and/or general weakness. The symptoms of food poisoning generally begin from a few hours to a few days after eating the affected food. They typically last hours to a few days, but can last longer. Often, other individuals eating the same food will exhibit similar symptoms which make the diagnosis of food poisoning more likely. The causes of food poisoning most often include contamination with various bacteria, viruses, or parasites. Other causes can include natural toxins (found naturally in many plants and some fish, etc.), other toxins that can arise from certain bacteria and fungi, and prions. It is always highly recommended to wash one’s hands thoroughly before eating and avoid eating undercooked or raw meat, poultry, fish, shellfish, sprouts, or eggs however, many cases of food poisoning are caused by poor sanitary conditions, spoilage, and/or improper food processing and/or storage of the food. Travelers should also be extremely careful. When in other countries, particularly third world countries, it is highly recommended to drink sealed bottled water, avoid ice and any food that has been washed or mixed with the local water (unless boiled and filtered), and avoid unpasteurized foods. Dehydration is one of the most serious complications from a case of food poisoning. It does not take long for a patient who has severe vomiting and/or diarrhea to become dehydrated. It is therefore important to drink plenty of fluids in cases of food poisoning. If symptoms last 2-3 days, one should seek medical care, so that the physician can obtain an appropriate history and perform a thorough physical examination. The physician will order the appropriate blood work and obtain stool samples and cultures. Treatment may include intravenous fluid and electrolyte replacement as well as antibiotics or anti-parasitic medication, if needed.

Note: There is a food poisoning that can mimic an allergic reaction called “Scrombroid poisoning.” The symptoms of this illness can include flushing and rash, rapid heart rate, lightheadedness/dizziness, headache, nausea, abdominal pain, and/or diarrhea. In severe cases, one may experience shortness of breath, wheezing, swelling of the throat or tongue, and/or decreased blood pressure which can be life-threatening. These symptoms all are typical of an allergic reaction, however, in scrombroid poisoning, there is no allergy and there is no contamination with bacteria, viruses, or parasites. The cause of this condition is a chemical called histadine that is naturally occurring in some fish (i.e., tuna, bluefish, mahi mahi, mackerel, sardines, herring, anchovies). When the fish is not properly stored, the fish spoils and certain bacteria grow and cause the histadine to convert to histamine. It is the histamine (which is one of the main culprits in causing allergic reactions), that is the cause for the allergic symptoms found in scrombroid poisoning. Treatment of mild symptoms can be treated with antihistamines, however, if symptoms become more severe or they become prolonged, one should go to the closest emergency room for treatment.

FOOD ALLERGIES:

Symptoms:

The symptoms of food allergies can be diverse. Some of the more common symptoms found with food allergies include: generalized itching (pruritus), itchy mouth and/or throat, hives (urticaria), other rashes, abdominal pain, diarrhea, vomiting, wheezing, shortness of breath, swelling (angioedema) , throat tightening, and/or anaphylaxis. As mentioned above, the symptoms usually occur within seconds to a couple of hours after exposure to the food. They can be very mild or very severe and life threatening. The most common foods associated with life-threatening reactions from foods include: peanuts, tree nuts, fish, and/or shellfish.

Most Common Food Allergies:

The most common food allergies in infants and children are milk, egg, soy, wheat, peanuts, and tree nuts. In adults, the most common food allergies are fish, shellfish, peanuts, and tree nuts. It should be noted that anyone can be allergic to any food. That food can cause symptoms ranging from very mild to very severe life-threating reactions.

Food protein-induced enterocolitis syndrome (FPIES):

Food protein-induced enterocolitis syndrome is a type of food allergy which usually affects infants and babies. The cause of the syndrome is usually due to a food, most commonly cow’s milk formula and soy-based formula. Breast milk may also contain food proteins that can cause this condition, however, this is rare. Other foods commonly associated with this syndrome can include oats, rice, sweet potatoes, squash, chicken, turkey, peas, green beans, and fish. Symptoms include vomiting and diarrhea (occasionally with blood), dehydration, weight loss, and failure to thrive. It is typical, however, for the symptoms to begin several hours after the food is consumed. This delay in symptoms makes it more difficult for this condition to be diagnosed. The diagnosis is further complicated by the fact that usual skin and blood testing done for food allergies usually are not be positive. Once the diagnosis is established, the food should be eliminated from the infant’s diet and alternative foods should be consumed. It is usually necessary to see a board certified allergist to diagnose this often “difficult to diagnose” problem.

Diagnosis and Treatment:

If one suspects food allergies, one should seek a board certified allergist. The allergists at Black & Kletz Allergy have had over 50 years of experience in diagnosing and managing food allergies and sensitivities in the Washington, DC, Northern Virginia, and Maryland metropolitan area. Food allergies can be diagnosed by a thorough history and physical examination along with prick skin testing and/or blood testing. The management varies but in most instances, avoidance of the food is the recommended treatment. If you feel that you may e an issue with food allergies or sensitivities, we would be happy to see you in one of our 3 convenient locations with offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. Please feel free to call our office or alternatively, you may click Request an Appointment and we will respond within 24 hours on the next business day. Black & Kletz Allergy is proud to provide quality allergy and immunology care in a relaxed caring environment.

Allergies and Asthma in the Washington, DC Area

Posted by Black & Kletz Allergy on July 28, 2014

A very common question that has been raised by many patients and especially parents of children with environmental and food allergies is: Why are we experiencing more and more allergies and asthma in the DC area now compared to a generation ago?

While it is possible that we are now able to detect and recognize allergic disorders more effectively than before, there is data to support the view that the actual incidence (the number of newly diagnosed cases) and the prevalence (the number of cases existing in the population) is increasing for the past several years. While the exact cause for this phenomenon is yet to be determined, there are some theories that try to explain the reasons behind it.

1. Genetics/Epigenetics:

Children born to parents who already have allergies are at higher risk for developing allergies. If one parent has allergies, the risk for the child is doubled and if both the parents have allergies, the risk is tripled. This increased likelihood to develop allergic disease because of their genes is called atopy. The genes can be “turned on and off” by some factors in our environment that we are exposed to. The role of viral infections in turning the allergic genes on and off is a subject of intense ongoing research.

2. Hygiene Hypothesis:

Several studies in Scandinavian countries revealed that children who grew up on farms exposed to farm animals have lower incidence of allergic diseases compared to children who grew up in cities in a “cleaner” environment. This indicates that the immune system needs to be exposed to micro-organisms like viruses and bacteria while at a developing stage in infancy, in order to respond appropriately later in life. Compared to our parents and grandparents, most of us are now living in a more “sterile“ environment due to better hygiene, immunizations, and antibiotics. While these helped us defeat many life-threatening infections, the inadequate exposure of our immune system to micro-organisms early-on may have resulted in a tendency to fight harmless substances like mites, pollen, and foods resulting in allergic diseases.

3. Diet:

We are now eating more processed foods and fewer vegetables and fruits than our forefathers did. Our diets also contain less omega-3 fatty acids and anti-oxidants. Vitamin D plays an important role in the modulation of immune function, and more and more people are currently being diagnosed as having a deficiency of Vitamin D, probably due to inadequate exposure to sunlight. The precise role of these factors in increased incidence of allergic disorders is being studied worldwide, though no conclusions have yet been reached. Although no conclusions have been reached regarding the cause of why the incidence and prevalence of allergies and asthma in Manassas, VA and the DC area have increased over recent years, it is clear that these conditions are very problematic for allergy sufferers. We, at Black and Kletz Allergy, strive to help alleviate your allergy and asthma symptoms in McLean, Virginia and the Washington, DC area, so that you can enjoy a high quality of life.

Summertime Sickness: Sinus Infection vs. the Common Cold

Posted by Black & Kletz Allergy on July 21, 2014

As the tree and grass pollen season is winding down in the Washington DC area, “summer colds” are playing a bigger role in symptoms that include stuffy nose, runny nose, eye irritation, sore throat, and cough in many people.

Also read: Sinus Infection vs. Cold: Symptoms & Treatment Options

The common cold is caused by a viral infection of the upper respiratory tract passages. Different strains of viruses are responsible for these infections in different seasons. Whereas rhinoviruses cause most of the colds in the winter, enteroviruses are more prevalent in summer.

The symptoms usually begin as sneezing spells followed by nasal congestion, runny nose, and a redness and burning sensation of the eyes. More serious eye problems, may be better handled by a Washington DC ophthalmologist. They are usually followed by a sore throat, occasional dry cough, and fatigue. Many individuals also experience headaches and a mild fever. The illness may last for 5 to 7 days and usually resolves by itself.

Though, no medication is needed to eradicate the infection, the symptoms can be relieved and the person can be made to feel more comfortable by taking some of the following steps:

Irrigating the nasal cavity with a saline spray and over-the-counter (OTC) oral decongestants to unclog the nostrils and help breathe easier. (Note that individuals with high blood pressure, heart problems, prostate conditions, and other various diseases should not use decongestants)

Though the OTC nasal decongestant sprays can give quicker relief, if they are used more than 3 days continuously, they can cause “rebound” congestion when their effect wears off. This can lead to a habituation and dependency and is called “rhinitis medicamentosa.” Therefore, never use an OTC nasal decongestant such as Afrin (oxymetazoline) or Neosynephrine (phenylephrine) more than 3 days.

OTC pain medications like acetaminophen and ibuprofen to relieve headache, achiness, and/or fever.

Gargling with warm salt water and using throat lozenges to soothe the throat irritation.

Get rest and drink plenty of oral fluids while the immune system is fighting the virus.

However, in some instances the upper respiratory infections can also progress to involve the linings inside the sinuses. (Sinuses are air-filled cavities within the facial bones and are present behind the forehead, around the eyes, and behind the cheek bones). This complication can not only prolong the duration of the illness, but can also result in additional symptoms such as fever, facial pain/tenderness, persistent thick and discolored nasal secretions, post-nasal drip, and/or frequent productive coughing, which are symptoms consistent with a sinus infection. People with a history of asthma may also experience aggravation of their breathing problems and the more frequent need for their rescue medications.

If the symptoms are persisting in spite of the OTC medications and comfort measures (especially if the symptoms last more than 1 week), it is time to consult your Manassas, VA sinus problem doctor for evaluation and treatment. Black & Kletz Allergy’s Washington, DC specialists will help you beat your summer allergies for good.

Hay Fever in the Washington, DC Area

Posted by Black & Kletz Allergy on June 4, 2014

Hay Fever in the DC area is manifested by tree and grass pollens in the Spring and ragweed pollen in the Fall. More specifically, the tree pollen usually begins to pollinate towards the end of February each year and continue pollinating into May or even early June. Grass pollen usually begins to pollinate in May and the peak of it is usually over by early July, but it still is present into August. Ragweed pollinates usually beginning in mid-August and ends with the first frost which is usually in late October. There are other weeds that cause hay fever in the DC area which are present throughout the Spring, Summer, and Fall. The medical name for hay fever is “allergic rhinitis.”

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