Peanut allergy is a type of food allergy distinct from nut allergies.

It is a type 1 hypersensitivity reaction

to dietary substances from peanuts that causes an overreaction of the immune system which in a small
percentage of people may lead to severe physical symptoms. It is estimated to affect 0.4-0.6% of the
population.[1] In England, an estimated 4,000 people are newly diagnosed with peanut allergy per year (11
per day); 25,700 having been diagnosed with peanut allergy by a clinician at some point in their lives. [2]
The most severe allergies in general can result in anaphylaxis,[3] an emergency situation requiring
immediate attention and treatment withepinephrine.
Peanut allergies are usually treated with an exclusion diet and vigilant avoidance of foods that may
contain whole peanuts or peanut particles and/or oils.
Contents
[hide]

1 Symptoms
2 Causes
3 Prevalence
4 Routes of exposure
5 Treatments

5.1 Injected peanut desensitization

5.2 Oral desensitization

6 Allergen-free peanuts
7 Peanut butter alternatives
8 References
9 External links

[edit]Symptoms
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: [4]

vomiting

diarrhea

urticaria (hives)

angioedema (swelling of the lips, face, throat and skin)

acute abdominal pain

exacerbation of atopic eczema

asthma

anaphylactic shock

Death

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 16 hours. Asthmatics with peanut sensitivity are
more likely to develop life threatening reactions".[4]
[edit]Causes
The exact cause of someone developing a peanut allergy is unknown. A 2003 study found no link to
maternal exposure to peanuts during pregnancy or during breast-feeding, [5] though the data shows a
linkage to the amount of time a child is breastfed. The same study indicated that exposure to soy milk or
soy products was correlated with peanut allergies. However, an analysis of a larger group in Australia
found no linkage to consumption of soy milk, and that the appearance of linkage is likely due to
preference to using soy milk among families with known milk allergies. [6]It's possible that exposure to
peanut oils in lotions may be implicated with development of the allergy.[7][8] Another hypothesis for the
increase in peanut allergies (and other immune and auto-immune disorders) in recent decades is
the hygiene hypothesis. Comparative studies have found that delaying introduction of peanut products
significantly increases the risks of development of peanut allergies, [9][10] and the American Academy of
Pediatrics, in response to ongoing studies that showed no reduction in risk of atopic disease, rescinded
their recommendation to delay exposure to peanuts along with other foods. They also found no reason to
avoid peanuts during pregnancy or while breastfeeding. [11] A study conducted jointly in Israel and United
Kingdom in 8600 children noted a nearly 10 fold increase in incidence of peanut allergy among U.K.
children compared to Israeli children. It was found that Israeli children were given peanuts at a much
younger age than those in the U.K. following recommendation of pediatricians in the U.K. [12] Pediatric
Associations in Britain and Australia recommend delaying introduction until age 3 and have not changed
their recommendations as of 2009.[13]
[edit]Prevalence
The Asthma and Allergy Foundation of America estimates that peanut allergy is one of the most common
causes of food-related death.[14] However, there is an increasing body of medical opinion that, while there

definitely are food sensitivities, the dramatic rise in frequency of nut allergies and more particularly the
measures taken in response to the threat show elements of mass psychogenic illness, hysterical
reactions grossly out of proportion to the level of danger: [15] "About 3.3 million Americans are allergic to
nuts, and even more6.9 millionare allergic to seafood. However, all told, serious allergic reactions to
foods cause just 2000 hospitalisations a year (out of more than 30 million hospitalisations nationwide).
And only 150 people (children and adults) die each year from all food allergies combined." Media
sensationalism has also been blamed.[16]
Prevalence among adults and children is similararound 1%but at least one study shows it to be on
the rise in children in the United States.[17] The number of young children affected doubled between 1997
and 2002.[18] 20% of children with a peanut allergy outgrow it.[19] In the USA, about 10 people per year die
from peanut allergies.[20]
One study has shown that peanut allergies also correlate with ethnicity; in particular, Native Americans
are less prone to be allergic to peanuts.[21]
[edit]Routes

of exposure

While the most obvious and dangerous route for an allergic individual is unintentional ingestion, some
reactions are possible through external exposure. Airborne particles in a farm- or factory-scale shelling or
crushing environment, or from cooking, can produce respiratory effects in exposed allergic individuals.
[22]
The belief that touch, smell, or simple proximity to peanut products can trigger anaphylaxis has
resulted in controversial bans on all peanut products from some entire medical and school facilities.
Empirical testing has discredited some reports of this type and shown others to be exaggerated. Others
remain in controversy. Residue on surfaces has been known to cause minor skin rashes, though not
anaphylaxis. In The Peanut Allergy Answer Book, Harvard pediatrician Michael Young characterizes this
secondary contact risk to allergic individuals as rare and limited to minor symptoms. [22] Some reactions
have been noted to be psychogenic in nature, the result of conditioning and belief rather than a true
chemical reaction. Blinded, placebo-controlled studies by Sicherer et al. were unable to produce any
reactions using the odor of peanut butter or its mere proximity.[22]
[edit]Treatments
Currently there is no confirmed treatment to prevent or cure allergic reactions to peanuts; however some
children have been recently participating in a method of treating the allergy to peanuts using mithridatism.
This method consists of feeding the children minuscule peanut traces which gradually become larger and
larger in order to desensitize the immune system to the peanut allergens. [18] Strict avoidance of peanuts is
the only way to avoid an allergic reaction. Children and adults are advised to carry epinephrine
injectors to treat anaphylaxis.
In order to diagnose allergies one must be prepared to first tell their doctor about their symptoms. These
symptoms should include any time intervals between the ingestion of the product and the time that the
symptoms began. A person should also include the exact type of symptoms and any other history of the
symptoms that may have also occurred from this same product. The time interval from the person's last
reaction will also be helpful to the doctor to determine the specific allergy or medical issue. One of the first
and easiest ways a doctor is able to diagnose the food allergy is by means of something called a Food
Challenge. During this challenge, the patient will be asked to eliminate the peanut allergen completely
from their diet for a time span from 10 to 14 days from start to finish. This type of elimination food

challenge time span if for the IgE mediated allergy. There will be a time span as long as 8 weeks for the
reaction called the cell mediated allergic reaction. By running these Food Challenges, doctors are able to
determine whether or not the suspicion of the peanut allergy is accurate. The doctor will look at the results
after the given time and if the symptoms have not changed, even after the peanuts have been eliminated
completely for such a long period of time, that the allergy is probably not the likely cause. If the symptoms
go away after the challenge then the allergy is probably the cause of the symptoms.
While several companies have developed promising drugs to counteract peanut allergies, trials have
been mired in legal battles.[23]
[edit]Injected

peanut desensitization

An early trial of injecting escalating doses of peanut allergen was conducted in 1996. However, one
participant died seconds later from laryngospasm due to a pharmacy error in calculating the dose. The
tragic incident itself abruptly ended one of the only studies on injected allergen desensitization to peanut
allergies.[24][25][26]
[edit]Oral

desensitization

A desensitization study at Duke University was done with escalating doses of peanut protein. Eight
children with known peanut allergy were given escalating doses of peanut protein in the form of a ground
flour mixed into apple sauce or other food. To enter the study peanut IgE level > 7 kU/L and a positive
skin prick test. The first day, they are given 0.1 mg of peanut protein, then the amount of peanut is
increased gradually to 50 mg, if tolerated, over that first day. About of the children tolerated 50 mg dose
by the end of the day, while the others were able to reach 12.5 mg or 25 mg. The children continued
taking daily doses of peanut at home, returning to the hospital every two weeks for dose increases until
they reached 300 mg peanut protein a day, or the equivalent of a single peanut. The maintenance phase
follows lasted up to 18 months, depending on how much peanut protein the child tolerated. Seven
children completed the study. These children were given a "food challenge" to peanut flour, exposing
them to up to nearly 8 grams, or the equivalent of more than 13 peanuts. Five of the seven children
tolerated the equivalent of 13 peanuts at the food challenge at the end of the study.[27] The childrens
immunologic findings were similar to those seen with other types of immunotherapyan initial rise
followed by a decline in peanut-specific IgE and IgG. They also had a rise in peanut-specific IgG4
throughout the study, which is thought to be a marker of protection in other forms of immunotherapy. [28]
In February 2009 a successful desensitization study was announced by Addenbrooke's
Hospital in Cambridge, England.[29] An example of the oral rush immunotherapy protocol is the
administration of diluted peanut at a dose of 0.1 mg (1 mL of a 1 gram/10L solution), and escalating by 10
fold every 30 minutes. Once a maximum dose of 50 mg is reached (1 mL of a 5 gram/100 mL solution), or
when systemic or local reaction occurs, the escalation is stopped. [24][30] The patient is maintained on this
maximum day one dose daily and the dose is escalated by a less rapid twofold increase each week, or
each month, depending on tolerance or protocol used. Reactions are treated with antihistamines, and if
needed anaphylactic drugs. Standard protocols are being developed by several clinical trials being
conducted in the United States.[31] Pre- and post-study serum anti-peanut IgE levels are measured, and
varying doses and escalation schedules are being compared to placebo in blinded study protocols. Actual
desensitization treatments are being carried out in the community using modified protocols. [32] Success
has been reported in both rapid (short duration of weeks) to slow rush protocol (spread over months) with
minimal systemic reactions. The first day of the protocol often required inpatient hospital admission, or

observation in a physician's office equipped with resuscitative drugs and with IV access). Frequent follow
up is required during the desensitization trials to treat reactions and modify the protocol if needed.
[33]
Because of the relative safety of oral rush immunotherapy, some in the medical community have
questioned if desensitization is better than living with peanut allergy.[34]
[edit]Allergen-free

peanuts

On July 20, 2007, the North Carolina Agricultural and 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 deactivation 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.[35]
[edit]Peanut

butter alternatives

Since peanut butter, a popular derivative of peanuts, is a widely used product, especially in the United
States and due to the prevalence of peanut allergies, many schools are offering peanut-free menu options
or implementing entirely nut-free policies. [36] For instance, sunflower seed butter can provide an
alternative in schools where peanut butter and peanuts have been banned. However, a small number of
people with peanut allergies may also be allergic to sunflower seed butter. According to one study a
person with a known peanut allergy suffered an acute reaction to a "nut-free" butter containing sunflower
seeds. [37]
From a nutritional perspective, sunflower butter contains almost four times as much vitamin E as peanut
butter, and about twice as much iron, magnesium, phosphorus and zinc.[38] Peanut butter contains higher
levels of protein and slightly less sugar and fat. [39]
[edit]References
1.

^ National Institutes of Health, NIAID Allergy Statistics

2.

^ Kotz, Daniel; Simpson, Colin R.; Sheikh, Aziz (2011). "Incidence, prevalence, and trends of
general practitionerrecorded diagnosis of peanut allergy in England, 2001 to 2005". Journal of Allergy and
Clinical Immunology 127 (3): 62330.e1. doi:10.1016/j.jaci.2010.11.021.PMID 21236479.

3.

^ National Report of the Expert Panel on Food Allergy Research, NIH-NIAID 2003[dead link]

4.

^ a bhttp://www.bda.uk.com/Downloads/peanutallergy.pdf[dead link] The British Dietetic Association.

Peanut Allergy Information for Dietitians. 1999

5.

^ Lack, Gideon; Fox, Deborah; Northstone, Kate; Golding, Jean; Avon Longitudinal Study of
Parents Children Study Team (2003). "Factors Associated with the Development of Peanut Allergy in
Childhood". New England Journal of Medicine 348 (11): 977
85. doi:10.1056/NEJMoa013536.PMID 12637607.[non-primary source needed]

6.

^ Koplin, Jennifer; Dharmage, Shyamali C.; Gurrin, Lyle; Osborne, Nicholas; Tang, Mimi L.K.;
Lowe, Adrian J.; Hosking, Cliff; Hill, David et al. (2008). "Soy consumption is not a risk factor for peanut
sensitization". Journal of Allergy and Clinical Immunology 121 (6): 1455
9.doi:10.1016/j.jaci.2008.03.017. PMID 18436294. Lay summary The Sydney Morning Herald (June 18,
2008).

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^ Lack, Gideon; Fox, Deborah; Northstone, Kate; Golding, Jean; Avon Longitudinal Study of
Parents Children Study Team (2003). "Factors Associated with the Development of Peanut Allergy in
Childhood". New England Journal of Medicine 348 (11): 977
85. doi:10.1056/NEJMoa013536.PMID 12637607.

8.

^ "Peanut Allergy May Be Linked To Skin Creams Containing Peanut Oil And To Soy Milk" (Press
release). University of Bristol. 10 March 2003. Retrieved June 7, 2012.

9.

^ "Food allergy advice may be peanuts". Science News174 (2). Dec 6 2008.

10.

^ Hst, Arne; Halken, Susanne; Muraro, Antonella; Dreborg, Sten; Niggemann, Bodo; Aalberse,
Rob; Arshad, Syed H.; Von Berg, Andrea et al. (2008). "Dietary prevention of allergic diseases in infants and
small children". Pediatric Allergy and Immunology 19 (1): 14. doi:10.1111/j.13993038.2007.00680.x. PMID 18199086.

11.

^ Greer, F. R.; Sicherer, S. H.; Burks, A. W.; American Academy of Pediatrics Committee on
Nutrition; American Academy of Pediatrics Section on Allergy Immunology (2008). "Effects of Early
Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of
Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and
Hydrolyzed Formulas". Pediatrics 121 (1): 18391.doi:10.1542/peds.2007-3022. PMID 18166574.

12.

^ Du Toit, G; Katz, Y; Sasieni, P; Mesher, D; Maleki, SJ; Fisher, HR; Fox, AT; Turcanu, V et al.
(2008). "Early consumption of peanuts in infancy is associated with a low prevalence of peanut
allergy". The Journal of allergy and clinical immunology 122 (5): 984
91.doi:10.1016/j.jaci.2008.08.039.PMID 19000582.[unreliable medical source?]

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^ "News Medical". Retrieved 11 March 2013.

14.

^ "Allergy Facts and Figures", Asthma and Allergy Foundation of

America http://www.aafa.org/display.cfm?id=9&sub=20&cont=517

15.

^ Christakis, Nicholas A. (2008-12-13). "This Allergies Hysteria Is Just Nuts". British Medical
Journal 337(1384). Retrieved 2012-11-14.

16.

^ Colver, A. (2006). "Are the dangers of childhood food allergy exaggerated?". BMJ 333 (7566):
4946.doi:10.1136/bmj.333.7566.494. PMC 1557974.PMID 16946341.

17.

^ 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
studyhttp://www.allerg.qc.ca/peanutallergy.htm#pressreldec903
^ a b Burks, A Wesley (2008). "Peanut allergy". The Lancet371 (9623): 1538

18.

46. doi:10.1016/S0140-6736(08)60659-5. PMID 18456104. Lay summary Reuters (May 2, 2008).

19.

^ "Institute of Child Health". Ich.ucl.ac.uk. Retrieved 2012-06-08.

20.

^http://www.aaaai.org/patients/advocate/2003/fall/reactions.stm[dead link]

21.

^ [http://www.allerg.qc.ca/peanutallergy.htm[dead link]"peanut allergy"]. Allerg.qc.ca. Retrieved 201007-08.

22.

^ a b c Young, Michael C. The Peanut Allergy Answer Book: 2nd Edition. Fair Winds Press. ISBN 159233-233-1.[page needed]

23.

^ "Trials of an allergy drug Remedy against peanuts is mired in legal battles". International Herald
Tribune. 2003-03-14. Retrieved 2010-07-08.

24.

^ a b Wood, Robert A. "Peanut Allergy: Presentations and Prospects for a Cure" (PDF). Retrieved
2010-07-08.

25.

^ "Answers from Dr. Greene | Allergy Care Guide". Pennmedicine.org. 2007-10-07. Retrieved
2010-07-08.

26.

^ Nelson, H; Lahr, J; Rule, R; Bock, A; Leung, D (1997). "Treatment of anaphylactic sensitivity to

peanuts by immunotherapy with injections of aqueous peanut extract1".Journal of Allergy and Clinical
Immunology 99 (6): 74451.doi:10.1016/S0091-6749(97)80006-1. PMID 9215240.

27.

^ "Progress Against Peanut Allergies". Webmd.com. Retrieved 2010-07-08.

28.

^ Murray, Terry (2007-03-20). "AAAAI: Peanut desensitization program for children shows
promise". Medicalpost.com. Retrieved 2010-07-08.

29.

^ "News from Cambridge UK". Cambridgenetwork.co.uk. Retrieved 2010-07-08.

30.

^ Clark, A. T.; Islam, S.; King, Y.; Deighton, J.; Anagnostou, K.; Ewan, P. W. (2009). "Successful oral
tolerance induction in severe peanut allergy". Allergy 64 (8): 121820.doi:10.1111/j.13989995.2009.01982.x.PMID 19226304.

31.

^ ClinicalTrials.gov NCT00580606 Peanut Sublingual Immunotherapy

32.

^ "Dallas Allergy". Dallas Allergy. Retrieved 2010-07-08.

33.

^ Beyer, Kirsten; Wahn, Ulrich (2008). "Oral immunotherapy for food allergy in children". Current
Opinion in Allergy and Clinical Immunology 8 (6): 553
6.doi:10.1097/ACI.0b013e32831952c8. PMID 18978471.

34.

^ Brown, H Morrow (2007). "Would Oral Desensitization for Peanut Allergy Be Safer Than
Avoidance?". Annals of Allergy, Asthma & Immunology 98 (2): 203.doi:10.1016/S1081-1206(10)607016. PMID 17304895.

35.

^ "Food Scientist Develops Process For Allergen-Free Peanuts, According To Lab".

ScienceDaily.com. Retrieved 2013-02-05.

36.

^ Groce, Victoria (2008-06-09). "Why is My Childs School Nut-Free? What food can she bring?".
foodallergies.about.com. Retrieved 2011-03-03.

37.

^ Hsu, Denise (2007). "Is "nut-free" sunflower seed butter safer for children with peanut
allergy?". The Medical Journal of Australia 198 (9): 542543.

38.

^ "Nutrient Data Laboratory Home Page". U.S. Department of Agriculture Agricultural Research
Service. 2012-10-09. Retrieved 2012-11-12.

39.

^ Thomas, R.G. "Sunflower Seed Butter and Almond Butter as Nutrient-Rich Alternatives to Peanut
Butter". USDA. Retrieved 2012-11-12.

External links

The "Peanut Patch": The future of peanut allergy treatments?

"Are Nut Bans Promoting Hysteria?" by Tara Parker-Pope at The New York Times (15 Dec 2008)

This allergies hysteria is just nuts by Nicholas A. Christakis (British Medical Journal, December
2008)

Peanut Allergy (Finnish)

Mayo Clinic's Peanut Allergy information

PeanutAllergy.com is a site for information and support networking of those with peanut allergies

PeanutAllergyUK is a support and discussion site for UK peanut allergy sufferers

Peanut allergy information from the Food Allergy & Anaphylaxis Network

"Peanut Allergy Overview". WebMD.

Allergy Aware.org. "Peanut Allergy". 2009. Web, 20 July 2011.

Goodman, Brenda (20 June 2011). "Food Allergies in Kids More Common Than Thought".
WebMD Health News. Retrieved 2 July 2011.

Laino, Charlene (16 March 2009). "New Therapy May Knock Out Peanut Allergy". Web MD.
Retrieved 31 July 2011.

Tips for Parents of Children with Peanut

Allergies
Published On Saturday, December 22, 2012 By critique. Under: Allergies. Tags: allergies, children,parents, peanut, tips

Are you the parent of a child who has a peanut allergy? If you are and if this is a first time experience for you, you may
be looking for some guidance. After all, knowing that your childs life is, literally, in your hands, can be overwhelming
for many parents.
One of the first things that you will want to do, as a parent, is talk to your child about their peanut allergy. This is
important to do as soon as your child can understand the concept of allergies and not eatingcertain foods. This time
often occurs at the preschool level. You may need to talk to your child more than once, but it is important to let them
know what could happen if they share food with friends or classmates. If your child is older or a teenager, you can
teach them proactive steps, such as checking all food labels.
As important as it is to talk to your child about their peanut allergy, it is extremely important to talk to anyone who
may come into contact with your child. These individuals include teachers, school nurses, family members, and
parents of friends. You may be surprised to know that many food allergies, includingallergic reactions to peanuts,
happen when a parents is not present. That is why it is extremely important that all adults know about your
childs allergic reactions to peanuts. When your child leaves your home to visit friends or family, pack safe snacks for
them to eat.
If you and your child are known for eating out, it is important that you ask as many questions as possible. You should
do so at all eating establishments, but it is particularly important to do at a bakery. Are all baked goods made in the
same spot, like on the same table? Even if not, are gloves changed? What are the chances that a peanut or peanut
butter can make its ways into other foods? You should know before feeding your child anything that you did not
prepare yourself.
Speaking of the foods that you do prepare yourself, be sure to read all food labels. When doing so, you may be
surprised just how many products have warnings that claim that peanuts may be present. Even if they only may, be,
you are still advised to proceed with caution and skip. Also, make sure that you always read labels, as food
manufacturers are known for updating or changing their ingredients.
It is also important to know how to handle a reaction. There is a good chance that your childs doctor will teach you
the proper steps that you should take, which will likely include administering medicine to help your child breathe. It
is also important to educate those around you too. Make sure that all relatives, parents of friends, and school teachers
know what to do in the event of an allergic reaction to peanuts. If medication is provided by your doctor, which it
should be, make sure the school has some and always carry the medication with you, like in your car or in your purse.
The above mentioned tips are just a few of the many tips that you will want to keep in mind, should your child have
a peanut allergy. It is no secret that caring for a child with a peanut allergy can be difficult and stressful, as you really
do need to watch every step that you and your child take. For that reason, there are a number helpful books out there

for parents like yourself, as well as online message boards wheresupport is provided, often by other parents just like
you.
PPPPP
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Originally posted. August 6, 2012