Sharing a global perspective on medical cases in allergy

One thing that has become clear over recent decades as we share more and more research globally and increase international collaborations is that people in different parts of the world see things differently. There is much to be learned from harnessing these different perspectives, and continuing to share knowledge and experience globally can go a long way to improving our understanding of diseases and improving healthcare outcomes.

World Allergy Organization Journal has published its first specially commissioned international case-based discussion article presenting commentaries from renowned experts from around the world in order to provide a global perspective on a specific case. Michael Kaliner, Series Editor, (Institute for Asthma & Allergy, Bethesda, USA) is planning to coordinate more international case-based discussions in the future to build an important collection of global cases in WAO Journal. Each article will include perspectives from at least five experts, each representing a particular region, Central and South America, Asia-Pacific, Middle East and Africa, Europe, and North America.

Michael Kaliner says: “This series provides a platform for ongoing case-based discussion at the international level for allergists and immunologists on co-morbidities in the clinical setting.”

In this first case, 45 year-old male with recurrent angioedema, originally presented by Jennifer Leiding and Douglas Beakes (USA), the patient experienced recurrent swelling of the tongue with no obvious cause. Stephen Dreskin (USA) comments on the usefulness of testing for Helicobacter pylori infection in such cases, as for this patient treatment for H. pylori didn’t eradicate the angioedema. Testing for H. pylori is not routine for such patients in Brazil as reported by Anete Grumach. Both Anete Grumach and Michihiro Hide (Japan) consider the possibility of angiotensin-converting enzyme inhibitors as a possible cause as this is not specifically excluded in the reported history of the patient, while Dr Avner Reshef (Israel) discusses a previous study of more than 900 patients with angioedema without urticaria to compare the range of identified causes. Massimo Triggiani (Italy) considers physical stimuli as a possible cause and association that may have been overlooked.

Michael Kaliner summarises this first WAO international case-based discussion by reflecting on the common points of discussion across the globe, as well as some interesting potential stimuli that could also be considered, such as reflux or snoring. While this discussion didn’t generate a specific new proposal for this patient, much can be gained from observing the different perspectives and the similarities and differences in the approaches to this case.

Lanny Rosenwasser, President, World Allergy Organization says: “The approach to care for allergic disease is quite similar around the five regions, but unique threads that can be ascertained may provide insight to better etiology, pathogenesis or treatment.”

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