Peanut allergy

Infobox_Disease
Name = Peanut allergy


Caption =
DiseasesDB = 29154
ICD10 = ICD10|T|78|4|t|66
ICD9 = ICD9|V15.01
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj =
eMedicineTopic =
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Peanut allergy is a type of food allergy, distinct from nut allergies. It is a hypersensitivity to dietary substances from peanuts causing an overreaction of the immune system which may lead to severe physical symptoms for millions of people [ National Institutes of Health, NIAID Allergy Statistics 2005 http://www.niaid.nih.gov/factsheets/allergystat.htm] . The Asthma and Allergy Foundation of America estimates that peanut allergy is the most common cause of food-related death. [ “Allergy Facts and Figures,” Asthma and Allergy Foundation of America http://www.aafa.org/display.cfm?id=9&sub=20&cont=517] . Prevalence among adults and children is similar — around 1% — but at least one study shows it to be on the rise in children. [ Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: A 5-year follow-up study http://www.allerg.qc.ca/peanutallergy.htm#pressreldec903] 25% of children with a peanut allergy outgrow it. [ Great Ormond Street Hospital for Children NHS Trust and UCL Institute of Child Health, Peanut Allergy - Family Factsheet http://www.ich.ucl.ac.uk/factsheets/families/F000279/] It is usually treated with an exclusion diet and vigilant avoidance of foods that may be contaminated with whole peanuts or peanut particles and/or oils. The most severe peanut allergies can result in anaphylaxis [ National Report of the Expert Panel on Food Allergy Research, NIH-NIAID 2003 http://www3.niaid.nih.gov/about/organization/dait/PDF/june30_2003.pdf] , an emergency situation requiring immediate attention and treatment with epinephrine.

ymptoms

Symptoms of peanut allergy are related to the action of Immunoglobulin E (IgE) and other anaphylatoxins, which act to release histamine and other mediator substances from mast cells (degranulation). In addition to other effects, histamine induces vasodilation of arterioles and constriction of bronchioles in the lungs, also known as bronchospasm (constriction of the airways).

Symptoms can include the following:The British Dietetic Association. Peanut Allergy Information for Dietitians. 1999 http://www.bda.uk.com/Downloads/peanutallergy.pdf]
* vomiting
* diarrhea
* urticaria (hives)
* angioedema (swelling of the lips, face, throat and skin)
* acute abdominal pain
* exacerbation of atopic eczema
* asthma
* anaphylactic shock

The British Dietetic Association warns that: "If untreated, anaphylactic shock can result in death due to obstruction of the upper or lower airway (bronchospasm) or hypotension and heart failure. This happens within minutes to hours of eating the peanuts. The first symptoms may include sneezing and a tingling sensation on the lips, tongue and throat followed by pallor, feeling unwell, warm and light headed. Severe reactions may return after an apparent resolution of 1-6 hours. Asthmatics with peanut sensitivity are more likely to develop life threatening reactions."The British Dietetic Association. Peanut Allergy Information for Dietitians. 1999 http://www.bda.uk.com/Downloads/peanutallergy.pdf]

While several companies have developed promising drugs to counteract peanut allergies, trials have been mired in legal battles. [ [http://www.highbeam.com/doc/1P1-72561487.html highbeam.com] ]

Treatments

:"See Anaphylaxis for the emergency treatment of an acute allergic reaction."

Currently there is no treatment to prevent or cure allergic reactions to peanuts. [ Information for the newly diagnosed - Food Allergy and Anaphylaxis Network http://foodallergy.org/NewlyDiagnosed/index.html ] Strict avoidance of peanuts is the only way to avoid an allergic reaction, which can be caused by less than 1/2000 of a peanut. [ Peanut allergy factsheet, New South Wales Department of Health http://www.health.nsw.gov.au/factsheets/general/peanut.html ]

Food allergy experts at the Duke University Medical Center believe that an immunotherapy treatment for peanut allergies will be available to affected people within five years. [ [http://news.yahoo.com/s/nm/20080502/hl_nm/peanut_allergy_dc;_ylt=AkzzviAdeBdQWEis7EL2Q7Ks0NUE Expert sees peanut allergy solution within 5 years - Yahoo! News ] ] Immunotherapy would be used to treat a person's immune response to peanuts from an allergic reaction to a nonallergic response. This is great news for the parents of affected children and adults living with the allergy. The condition is actually becoming more common affecting about 1% of children in total. The number of affected people doubled between 1997 and 2002. [ [http://news.yahoo.com/s/nm/20080502/hl_nm/peanut_allergy_dc;_ylt=AkzzviAdeBdQWEis7EL2Q7Ks0NUE Expert sees peanut allergy solution within 5 years - Yahoo! News ] ]

Deaths from peanut allergy

Peanuts are the most common source of fatal food allergic reactions. Fifty-four percent of fatal food allergic reactions reported in the United States from 2001-2006 were from peanuts. [ [Further fatalities caused by anaphylactic reactions to food: 2001 to 2006 - Food Allergy and Anaphylaxis Network http://www.prnewswire.com/mnr/faan/27010 ]

Reports of death from peanut allergy in 2008 include:

* Andrew Michael Smith (age 8) died February 2008 after he accidently came into contact with peanut allergens at home. [cite news |url=http://tristatehomepage.com/content/fulltext/?cid=5678|title=Boy battled peanut allergy|date=2008-04-01 |publisher=TriState]
* Carol Kiener, (age 66) died March 2008 after suffering a severe allergic reaction to peanuts. [cite news |url=http://www.johnsoncitypress.com/Detail.php?Cat=LOCALNEWS&ID=62155|title=Former educator, wife of ex-Sessions judge dies of allergic reaction |date=2008-03-24 |publisher=JohnsonCityPress.com]
* Paul Anthony Thurston (age 30) died April 2008 after being served a peanut butter sandwich in jail. [cite news |url=http://www.foxnews.com/story/0,2933,351975,00.html|title=Michigan Prison Inmate Dies After Eating Peanut Butter Sandwich|date=2008-04-21 |publisher=FoxNews.com]
* Daniel Sargent (age 30) died July 2008 after eating a cookie that had peanut butter in it at a party. [cite news |url=http://www.heraldnet.com/article/20080704/NEWS01/546172117/0/SPORTS |title=Man's death a stark reminder of food allergy risks |date=2008-07-04 |publisher=Everett, Washington Herald]
* Brian Hom II (age 18) died July 2008 after eating a dessert containing traces of peanuts while at a resort in Cabo San Lucas. [cite news|url=http://www.evergreentimes.com/072508/an.htm|title=An untimely tragedy|date=2008-07-11 |publisher=Evergreen Times]
* Dexter Skinner (age 16) died July 2008 after eating a chocolate bar. [cite news |url=http://www.dinningtontoday.co.uk/news/Maltby-youngster-dies-after-eating.4279749.jp|title=Maltby youngster dies after eating chocolate |date=2008-07-11 |publisher=Guardian]

The 2005 death of Christina Desforges, which was initially reported as a result of exposure to peanuts, spurred many parents to speak out about the dangers of peanut butter and jam sandwiches at schools or peanut shells on the floors of restaurants. [cite news |url= http://www.readthehook.com/stories/2006/01/05/newsNuttyKillerPeanutPolic.html |title=Nutty killer: Peanut policy perplexes parents |date=2006-01-05 |accessdate=2006-12-13 |publisher=Hook weekly] However, according to a coroner's statement in March 2006, Ms. Desforges did not die of anaphylactic shock caused by a kiss from her boyfriend after he ate a peanut butter snack, but in fact died as a result of asthma-linked respiratory failure, which was triggered by tobacco smoke at a party. Research by Jennifer Maloney suggests that peanut allergens normally leave the saliva after about an hour. [http://www.medpagetoday.com/AllergyImmunology/2005AAAAIMeeting/tb/2803]

Allergen-Free Peanuts

On July 20, 2007, the North Carolina Agricultural & Technical State University announced that one of its scientists, Dr. Mohamed Ahmedna, had developed a process to make allergen-free peanuts. Initial testing showed a 100 percent inactivation of peanut allergens in whole roasted kernels, and human serums from severely allergic individuals showed no reaction when exposed to the processed peanuts. Food companies have expressed an interest in licensing the process, which purportedly does not degrade the taste or quality of treated peanuts, and even results in easier processing to use as an ingredient in food products. [North Carolina A & T State University Press Release, July 23, 2007]

See also

* Allergy
* Nut allergy
* Anaphylaxis
* Food allergy
* Asthma

External links

* [http://www.aafa.org Asthma and Allergy Foundation of America]
* [http://www.nih.gov The National Institutes of Health]
* [http://www.foodallergy.org The Food Allergy & Anaphylaxis Network]
* [http://www.medicinenet.com/script/main/art.asp?articlekey=15618 medicinenet.com]
* [http://www.allerg.qc.ca/peanutallergy.htm Peanut allergy: where do we stand? John Weisnagel, M.D.]
* [http://www.alert4allergy.org alert4allergy.org - a free service for people in Britain with food allergy.]
* [http://www.peanutallergyuk.co.uk A discussion forum for UK peanut allergy sufferers]
* [http://www.leapstudy.co.uk The Leap Study - an NHS study into links between eczema and peanut allergy]
* [http://allergy.hyperboards.com/index.php Peanut Allergy public discussion forums and support group]
* [http://www.killerpeanut.com Instant and Free Peanut Allergy Translations for food preparers, medical staff and custom officials]
* [http://www.ncat.edu/press_releases/disp_release.php?ID=3132 N.C. A&T food scientist develops process for allergen-free peanuts]

References