Background: This study aimed to elucidate the current implementation status of medical practices for adult patients with food allergies (FA) in Japan.

Methods: A survey was conducted from October to December 2021 at the allergy specialist training facilities of the Japanese Society of Allergology, examining the status of medical practices for patients with food allergies in 2019.

Results: Of the 819 facilities, 273 (33%) treated childhood or adult patients with FA, 8% did not treat patients with FA, and 59% did not respond to the survey. Among the facilities, 24% treated adult patients with FA across various specialties: dermatology (45%), pediatrics (37%), otolaryngology (16%), internal medicine (14%), and ophthalmology (0%). The total number of adult patients with FA at the 273 facilities was 9260, with 37% having childhood-onset and 63% having adult-onset. Among childhood-onset cases, 99% were treated in pediatric departments. The oral food challenge (OFC) was available at 198 facilities (73%), including pediatrics (94%), dermatology (66%), internal medicine (30%), and otolaryngology facilities (0%). A total of 934 OFCs were conducted in adults, of which 63% were performed in pediatric departments.

Conclusion: Medical practices for adult patients with FA in Japan remain insufficient, with inadequate transitional care for childhood-onset cases. Strengthening medical support, including OFC for adult patients with FA, and establishing seamless transitional care is necessary.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a disease with marked elevation of blood eosinophil associated with various symptoms in the respiratory tract, gastrointestinal tract, peripheral nerves, and skin due to systemic vasculitis. Here, we report a case of EGPA in which rhinosinusitis was treated with endoscopic sinus surgery (ESS) with good results. A 49-year-old man who developed bronchial asthma at age 48 was diagnosed with EGPA in our hospital. Treatment with prednisolone (PSL) and mepolizumab relieved peripheral blood eosinophilia and symptoms caused by systemic vasculitis. However, rhinosinusitis with nasal polyps and olfactory disorder worsened one year after the start of treatment. Topical administration of betamethasone did not improve rhinosinusitis and olfactory disorder, so ESS was performed. At the one-year follow-up, no recurrence of rhinosinusitis and olfactory disorder was observed. ESS may be an effective treatment for rhinosinusitis associated with EGPA.