Clinical Allergy Diagnosis and Management
Allergic diseases affect nearly one-fourth of the population and cause or contribute to significant chronic illness. Allergic diseases are common and are seen by a wide variety of health care providers. In Clinical Allergy: Diagnosis and Management, the a
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Current Clinical Practice Neil S. Skolnik, SERIES EDITOR
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Gerald W. Volcheck
Clinical Allergy Diagnosis and Management
Gerald W. Volcheck Consultant, Division of Allergic Diseases, Mayo Clinic Rochester, MN Assistant Professor of Medicine, College of Medicine, Mayo Clinic
Series Editor Neil S. Skolnik Abington Memorial Hospital Abington, PA 19001 USA
ISBN 978-1-58829-616-0 e-ISBN 978-1-59745-315-8 DOI: 10.1007/978-1-59745-315-8 Library of Congress Control Number: 2008936256 © 2009 Mayo Foundation for Medical Education and Research. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, recording, or otherwise, without written permission from Mayo Foundation, Section of Scientific Publications, Plummer-10, 200 First Street SW, Rochester, MN 55905. Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. The authors, editors, and publisher have exerted efforts to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of health care providers to ascertain the FDA status of each drug or device planned for use in their clinical practice. Cover illustration: Figure 6, Chapter 2, “Environmental Allergens” Printed on acid-free paper 9 8 7 6 5 4 3 2 1 springer.com
To my wife Mary Margaret and children Joseph and Allison for their love, encouragement, and support.
Series Editor’s Introduction
Diseases exacerbated by allergy, as well as primary allergic disorders, are among the most common disorders seen by primary care physicians. Seldom does an office session occur where there are not two or three patients with some manifestation of allergic disease ranging from asthma, to allergic rhinitis, to urticaria. The science of allergy and immunology has exploded over the last two decades, making it important for physicians to have an effective reference to help update their knowledge of the field. In a recen
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