Pw. Ewan, CLINICAL-STUDY OF PEANUT AND NUT ALLERGY IN 62 CONSECUTIVE PATIENTS -NEW FEATURES AND ASSOCIATIONS, BMJ. British medical journal, 312(7038), 1996, pp. 1074-1078
Objective-To investigate clinical features of acute allergic reactions
to peanuts and other nuts. Design-Analysis of data from consecutive p
atients seen by one doctor over one year in an allergy clinic at a reg
ional referral centre. Subjects-62 patients aged 11 months to 53 years
seen between October 1993 and September 1994. Main outcome measures-T
ype and severity of allergic reactions, age at onset of symptoms, type
of nut causing allergy, results of skin prick tests, and incidence of
other allergic diseases and associated allergies. Results-Peanuts wer
e the commonest cause of allergy (47) followed by Brazil nut (18), alm
ond (14), and hazelnut (13). Onset of allergic symptoms occurred by th
e age of 2 years in 33/60 and by the age of 7 in 55/60. Peanuts accoun
ted for all allergies in children sensitised in the first year of life
and for 82% (27/33) of allergies in children sensitised by the third
year of life. Multiple allergies appeared progressively with age. The
commonest symptom was facial angioedema, and the major feature account
ing for life threatening reactions was laryngeal oedema. Hypotension w
as uncommon. Of 55 patients, 53 were atopic-that is, had positive skin
results of tests to common inhaled allergens-and all 53 had other all
ergic disorders (asthma, rhinitis, eczema) due to several inhaled alle
rgens and other foods. Conclusions-Sensitisation, mainly to peanuts, i
s occurring in very young children, and multiple peanut/nut allergies
appear progressively. Peanut and nut allergy is becoming common and ca
n cause life threatening reactions. The main danger is laryngeal oedem
a. Young atopic children should avoid peanuts and nuts to prevent the
development of this allergy.