Journal of Clinical and Cellular Immunology
Open Access

Abstract

Under-Recognized Effects of Allergic Disorders on Neuropsychiatric Symptoms, in Subjects with Limited Expressive Language

Harumi Jyonouchi

Diagnosis of allergic diseases are based on detailed clinical history and careful physical examinations supported by skin test (ST) reactivity and/or presence of allergen specific IgE in the serum for IgE-mediated allergy. Clinicians tend to focus on clinical manifestations that occur in the organs affected directly by allergen exposure. However, many epidemiological studies support a positive association between neuropsychiatric symptoms and allergic diseases, although in most epidemiological studies, allergy diagnoses are based on self-reported survey results and/or billing codes. With current diagnostic tools heavily relying on clinical history, individuals with limited expressive language (LEL) imposes a significant challenge for practicing clinicians. LEL subjects also often exhibit neuropsychiatric symptoms associated with their primary medical conditions. In such subjects, it is often very difficult to differentiate neuropsychiatric symptoms associated with pain and discomfort caused by allergic diseases from those caused by their primary medical conditions. In addition, lack of appreciation of their allergic conditions by the care-givers may further frustrate LEL subjects, rendering worsening their behavioral symptoms. This review was formulated to address the association between neuropsychiatric symptoms and allergic disorders, emphasizing the need for the special attention required when evaluating LEL subjects for allergic diseases. Since many allergic diseases are relatively easily treatable with benign medications, clinicians need to carefully evaluate and treat common allergy conditions in LEL subjects, especially prior to treating them with neurotropic medications, which likely cause more undesirable side effects.