Presentation
It may be difficult to predict whether a person will be allergic to one unique protein allergen present in one food only, or several similar cross reactive proteins present in multiple foods. [allergy.org.au]
Table 2 Clinical symptoms DISCUSSION In our cohort, more patients presented with peanut than cashew allergy, which is in keeping with previous studies. 1– 3 However, anaphylaxis was more common in the cashew group. [adc.bmj.com]
Primary nut allergy presents most commonly in the first five years of life, often after the first known ingestion with typical rapid onset of IgE-mediated symptoms. [bsaci.org]
The proteins present in tree nuts are very different to those found in peanuts and someone who is allergic to peanuts will not necessarily be allergic to tree nuts. [news-medical.net]
Presented July 20, 2017. Follow Medscape Allergy & Clinical Immunology on Twitter @MedscapeAllergy and Tara Haelle @TaraHaelle [medscape.com]
Entire Body System
- Swelling
In anaphylaxis, the throat and airways swell and become blocked. This makes it extremely difficult, sometimes even impossible, to breathe. [healthline.com]
Symptoms can range from a mild runny nose to the life threatening symptoms of anaphylaxis, which include throat swelling, shortness of breath, and shock. The same person can have different nut allergy symptoms at different points in time. [medicalnewstoday.com]
Signs include trouble breathing or swallowing, swelling in your mouth or throat, a change in your voice, or wheezing. Immediately give 1 shot of epinephrine only into the outer thigh muscle. [drugs.com]
Symptoms of severe allergic reactions (anaphylaxis), include any of the following; difficult/noisy breathing, swelling of the tongue, swelling/tightness in the throat, difficulty talking/hoarse voice, wheeze or persistent cough, persistent dizziness and [allergy.org.au]
I looked in the mirror to find my face swelling up like an inflated balloon. I knew something was terribly wrong. I called 911, then ran to the porch to wait for an ambulance. [pbs.org]
- Weakness
[…] include any of the following symptoms: Flushed face, hives or a rash, red and itchy skin Swelling of the eyes, face, lips, throat and tongue Trouble breathing, speaking or swallowing Itchy skin Anxiety, distress, fainting, paleness, sense of doom and weakness [unlockfood.ca]
Or you may feel very light-headed or suddenly feel weak, confused, or restless. You have been given an epinephrine shot, even if you feel better. [myhealth.alberta.ca]
[…] voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea Cardiovascular (heart): paler than normal skin colour/blue colour, weak [foodallergycanada.ca]
I had a pulse, but a weak one. And I’d been without air for at least two minutes. When I got to the emergency room at Lincoln Memorial Hospital, I was still in respiratory arrest. There, the doctors took over. [pbs.org]
- Asymptomatic
[…] that a patient is sensitized to can increase with age.4 In the case of nut-induced anaphylaxis, as with other foods, symptoms usually present within minutes of ingestion.5 Biphasic reactions, in which return of anaphylactic symptoms occurs following an asymptomatic [thermofisher.com]
Respiratoric
- Rhinitis
While walnut oral immunotherapy was generally well tolerated, we frequently observed oral allergy/itching associated with dosing in our cohort, which was an atopic group (75% allergic rhinitis). [mdedge.com]
If you are allergic to walnut pollen, you may experience symptoms of allergic rhinitis. Pecans and walnuts are closely related, so some people who are allergic to one are also allergic to the other. [verywellhealth.com]
Other allergies may be present Food allergy is more common in people who have other allergies such as allergic rhinitis (hay fever), asthma or eczema. [allergy.org.au]
[…] reactions are acute in onset, with symptoms occurring within minutes or up to a few hours after ingestion.8 Skin reactions are the most common clinical manifestations of allergic reactions to food.1 Severity of coexisting atopic diseases—such as allergic rhinitis [thermofisher.com]
- Throat Tightness
Tree Nut Allergy Symptoms and Diagnosis A tree nut allergy may cause a person to exhibit the following signs and symptoms within two hours of consuming tree nut products: Nausea and vomiting Abdominal pain and cramps Difficulty swallowing, throat tightness [jaxallergy.com]
Symptoms of anaphylaxis generally include two or more of the following body systems: Skin: hives, swelling (face, lips, tongue), itching, warmth, redness Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness [foodallergycanada.ca]
The release of these chemicals can cause someone to have some or all of the following problems: wheezing trouble breathing coughing hoarseness throat tightness stomachache vomiting diarrhea itchy, watery, or swollen eyes hives red spots swelling a drop [brennerchildrens.org]
This can cause symptoms such as: wheezing trouble breathing coughing sneezing hoarseness throat tightness stomachache vomiting diarrhea itchy, watery, or swollen eyes hives swelling a drop in blood pressure dizziness or fainting anxiety or a feeling something [kidshealth.org]
In addition, older children may report symptoms that are associated with severity (eg, throat tightness). 21 TN allergy has a lower likelihood of resolution compared with other food allergies. [dovepress.com]
- Rhinorrhea
Respiratory tract symptoms: laryngeal edema, rhinorrhea, and bronchospasm. Gastrointestinal-related signs and symptoms: nausea, vomiting, abdominal pain, and diarrhea. [thermofisher.com]
- Throat Irritation
The company said the most common adverse effects were abdominal discomfort or pain, coughing, hives, itching, nausea, throat irritation and vomiting. [edition.cnn.com]
Gastrointestinal
- Nausea
Symptoms often occur directly after exposure to nuts and may include: Skin rash Itching or tingling in or around the mouth and throat Digestive symptoms (diarrhea, abdominal cramps, nausea or vomiting) Tightness of the throat Shortness of breath or wheezing [allergyeasy.com]
The company said the most common adverse effects were abdominal discomfort or pain, coughing, hives, itching, nausea, throat irritation and vomiting. [edition.cnn.com]
They can include: itchy skin hives a tingling feeling in the mouth or throat a runny nose or congestion nausea anaphylaxis — a life-threatening reaction that can cause trouble breathing, swelling in the throat, fainting, dizziness and a drop in blood [childrenshospital.org]
Symptoms The symptoms of an allergic reaction usually arise within 30 minutes of eating the tree nut and may include the following: Diarrhea Difficulty swallowing Abdominal cramps and pain Nausea and vomiting Runny nose Nasal congestion Itching in the [news-medical.net]
- Abdominal Pain
Tree Nut Allergy Symptoms and Diagnosis A tree nut allergy may cause a person to exhibit the following signs and symptoms within two hours of consuming tree nut products: Nausea and vomiting Abdominal pain and cramps Difficulty swallowing, throat tightness [jaxallergy.com]
Mild to moderate reactions consist of any one or more of the following: hives or welts, swelling of the lips/face/eyes, tingling of the mouth, abdominal pain or vomiting Severe reactions (anaphylaxis) include one or more of the following: Difficulty/noisy [schn.health.nsw.gov.au]
Gastrointestinal-related signs and symptoms: nausea, vomiting, abdominal pain, and diarrhea. [thermofisher.com]
- Choking
Not actual peanuts—they are a serious choking hazard—but things made from peanuts, like peanut butter. [healthychildren.org]
Turn them onto their side to prevent choking if they vomit. If breathing stops, begin CPR. Step #3: Identify the cause Identifying the foods and ingredients the person ate recently can help narrow down the cause of the reaction. [franciscanhealth.org]
He warns that babies and very young children might choke on peanuts and should not eat them. You can use smooth peanut butter or snacks containing peanut butter. But ask your child’s pediatrician the best way to give peanut products to your child. [stlouischildrens.org]
However, avoid whole nuts and chunky nut butters because they are choking hazards. Try smooth nut butters like almond or cashew, spread thinly on toast or crackers instead. [unlockfood.ca]
Peanut, tree nut and seed avoidance strategies advised will largely be dictated by choking hazards in infants, and the risks of cross contamination, or substitution of one nut for another in commercially prepared foods. [allergy.org.au]
Eyes
- Eye Swelling
Her lips and eyes swelled up," said Miscio. "It was very scary." By the time Miscio raced home from her job, her mother, who was watching the little girl, had given her Benadryl. [today.com]
People with a nut allergy may experience the following symptoms after exposure to some or all types of nut: coughing stomach pain nausea sneezing diarrhea itching, particularly around the face and mouth puffy or runny eyes swelling lips a gravelly throat [medicalnewstoday.com]
In August, another episode of anaphylaxis landed her in the emergency room: She began to vomit and suffered chest tightness and eye swelling after eating Indian food her parents suspect contained cashews—despite having triple-checked with the restaurant [sciencemag.org]
Skin
- Eczema
The guidelines divide babies into three groups: Those with severe eczema (persistent or recurrent eczema who need prescription creams frequently) and/or egg allergy Those with mild to moderate eczema Those who don't have any eczema or food allergy For [healthychildren.org]
Babies at high risk include those with a diagnosed egg allergy or severe eczema (babies with severe eczema need prescription medications to treat the problem). Eczema is a skin problem that causes dry, itchy skin. [stlouischildrens.org]
ECZEMA – A link is sometimes seen between the skin condition known as atopic dermatitis (eczema) and food allergies. GENETICS – The risk of any food allergy increases if family members have food allergies. [enjoylifefoods.com]
It might explain the association between eczema and peanut allergy in children, because such lotions are applied to soothe the itching. However, some research shows that early exposure to peanuts can prevent later allergic reactions. [sciencefocus.com]
[…] first randomized, open-label, controlled trial to investigate the most effective strategy for preventing peanut allergy in infants at high risk for the allergy. 640 infants between 4-11 months of age at high risk for peanut allergy (history of severe eczema [pedclerk.uchicago.edu]
- Angioedema
Figure 3: Angioedema http://www.babyrashclinic.com/face-rash-on-baby-due-to-angioedema/ Diagnosis The diagnosis of a peanut allergy is dependent on a clear and specific history confirmed by testing ( Figure 4 ). [pedclerk.uchicago.edu]
Peanut allergy results in urticaria, angioedema, and anaphylaxis within 30 minutes of exposure to a peanut allergen [1]. It may also cause a late-phase allergic reaction. [dermnetnz.org]
Some common symptoms include: an itchy sensation inside the mouth, throat or ears a raised itchy red rash ( urticaria, or "hives") swelling of the face, around the eyes, lips, tongue and roof of the mouth (angioedema) vomiting Read more about the symptoms [nhs.uk]
[…] fatal food-induced anaphylaxis.9 18% to 40% Tree nut allergies account for 18 percent to 40 percent of cases of anaphylaxis.4,6-8 The most common clinical manifestations of allergic reactions to food include:1 Skin reactions: acute urticaria (hives), angioedema [thermofisher.com]
Psychiatrical
- Fear
"As a parent of two children with nut allergies, I know the fear parents face and the need for better treatments," said Kim, member of the UNC Children's Research Institute. [sciencedaily.com]
I kept thinking to myself, are my fears overblown? Or am I really an irresponsible mother for thinking we could safely travel with a peanut allergic child? Most of my fears were unfounded. [earthtrekkers.com]
You can't go home and have a peanut butter sandwich, but you should be able to walk out with less fear," Spergel said. [cbsnews.com]
“The quality of life of patients and their caregivers is adversely affected due to fear and anxiety about accidental ingestions,” he added. [nytimes.com]
Print or share this article Have No Fear, the Halloween 2019 Edition of the Safe Snack Guide is Here! [snacksafely.com]
Neurologic
- Tingling
Symptoms often occur directly after exposure to nuts and may include: Skin rash Itching or tingling in or around the mouth and throat Digestive symptoms (diarrhea, abdominal cramps, nausea or vomiting) Tightness of the throat Shortness of breath or wheezing [allergyeasy.com]
They can include: itchy skin hives a tingling feeling in the mouth or throat a runny nose or congestion nausea anaphylaxis — a life-threatening reaction that can cause trouble breathing, swelling in the throat, fainting, dizziness and a drop in blood [childrenshospital.org]
Peanut allergy signs and symptoms can include: Runny nose Skin reactions, such as hives, redness or swelling Itching or tingling in or around the mouth and throat Digestive problems, such as diarrhea, stomach cramps, nausea or vomiting Tightening of the [mayoclinic.org]
In addition to potential life-threatening anaphylaxis, less severe allergic reactions to peanuts and tree nuts include itchy skin, itchy eyes, itchy ears, rashes, conjunctivitis, hives, swelling, eczema, runny nose, sneezing, tingling, dryness in the [enjoylifefoods.com]
Mild to moderate reactions consist of any one or more of the following: hives or welts, swelling of the lips/face/eyes, tingling of the mouth, abdominal pain or vomiting Severe reactions (anaphylaxis) include one or more of the following: Difficulty/noisy [schn.health.nsw.gov.au]
- Headache
[…] nausea, pain/cramps, vomiting, diarrhea Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache [foodallergycanada.ca]
Some people have negative or adverse reactions to food (such as headache or bloating) that are not caused by allergies. These can be caused by factors such as food poisoning, toxic reactions or food sensitivities (intolerance). [betterhealth.vic.gov.au]
Treatment
If approved, this will become the first FDA approved treatment for peanut allergy. [edition.cnn.com]
The new treatment could be a huge change for those who deal with severe allergies. [today.com]
“We were surprised how long the effects of the treatment lasted,” Nadeau said. [med.stanford.edu]
Treatment for nut allergies The only treatment for food allergies is to avoid the food that causes your allergy. Even if you are careful, it is difficult to avoid all contact with a specific food. [betterhealth.vic.gov.au]
Patients could use epinephrine and go to the emergency room after an accidental exposure, but Casale said the need for effective treatment was clear. Peanut allergies can be deadly: This treatment might do more harm than good, study says The U.S. [eu.usatoday.com]
Prognosis
I was stable, but comatose, and the prognosis was grim. As I lay in a coma in the ICU, my parents and Charlie at my side, doctors revealed the distinct possibility of severe brain damage. ••• Some people worry about earthquakes. [pbs.org]
Center for Biologics Evaluation and Research (CBER) voted to support the use of Palforzia (formerly AR101) for peanut allergy. [46] [47] [48] The price has not been set as of September 2019 but is proposed to be between $US3,000 and 20,000 per year. [49] Prognosis [en.wikipedia.org]
Epidemiology
Epidemiology In the United States, the prevalence of peanut allergy in children has increased from 0.4% in 1997 to ~2% in 2010. The exact causes for this rising prevalance remain unknown. [pedclerk.uchicago.edu]
Limited epidemiological data suggest varying prevalence in different geographical areas. Primary nut allergy affects over 2% of children and 0.5% of adults in the UK. [bsaci.org]
The epidemiology of nut allergies was significantly different between Geneva and Valencia, possibly because of differences in age, diet, and environmental exposure to nuts, Dr Brough pointed out. Table 1. [medscape.com]
[…] to what researchers know so far on the topic: Peanut allergies are on the rise — but so are lots of allergies Trends in Allergic Conditions Among Children: United States, 1997-2011 ( CDC ) The overall increase in allergies is still a big mystery in epidemiology [vox.com]
Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018 Jan;141(1):41-58. Brough HA, et al. [thermofisher.com]
Pathophysiology
Pathophysiology of food allergy. Pediatr Clin North Am. 2011; 58(2): 363–76. DOI: 10.1016/j.pcl.2011.02.012. Journal Al-Muhsen S, Clarke AE, Kagan RS. Peanut allergy: an overview. CMAJ 2003; 168: 1279–85. [dermnetnz.org]
Blinded, placebo-controlled studies were unable to produce any reactions using the odor of peanut butter or its mere proximity. [31] Pathophysiology [ edit ] The allergy arises due to dendritic cells recognizing peanut allergens as foreign pathogens. [en.wikipedia.org]
Prevention
[…] from early infancy is safe and effective for preventing peanut allergy in at-risk infants. [pedclerk.uchicago.edu]
Preventing accidental exposure Foods your child can safely eat may come in contact with tree nuts at home, at school, and in restaurants. To help prevent accidental exposure: Teach your child not to eat snacks that are given outside the home. [saintlukeskc.org]
To prevent allergic reactions, one should avoid all nuts and foods containing nuts. This is easier said than done. Food labels should be scrutinized and dishes of unknown origin should be avoided. [medicinenet.com]
"Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel". [en.wikipedia.org]
As the LEAP trial did, these new data give "us more impetus to put some of these tree nuts into the diet early to try to prevent the development of nut allergy," Dr Sampson said. [medscape.com]