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Peanut Allergy

Peanut, a very common food item, is one of the most allergenic food in the world. Even a little amount can trigger a reaction in those with peanut allergy.

What is peanut allergy?

Peanut allergy is an adverse reaction of the body towards exposure to peanuts.

  • The body reacts towards peanut like it is a dangerous substance.
  • This reaction can be caused by eating, having skin contact or inhaling peanut protein.

How does it occur?

Peanut allergy occurs when some allergenic proteins in the peanut triggers the body’s immune response to produce certain antibodies. The body produces specific IgE antibody to peanuts. These antibodies bind to certain cells called mast cells and cause them to release certain chemicals into the bloodstream. These chemicals (example: histamine) cause symptoms to appear.

How common is this condition?

  • Prevalence in increasing in the Western countries compared to the relatively fewer cases in Asian countries.
  • In the USA, incidence of peanut allergy is 0.8% in recent studies and prevalence have doubled in children under age 5 years 1.
  • The onset is usually within the first year of life.
  • One third of children outgrow this allergy by the age 5 years.
  • For others, the allergy persist for life.

How would peanut allergy present?

Reactions can occur with minimal contact or contact with small amounts of peanut protein. These reactions commonly involve the eyes, mouth, skin, intestines and lungs. It can happen soon after or hours after contact. Reactions can be severe even on the first reported exposure. Symptoms may occur in isolation or in combination:

  • Urticaria (hives/itchy, red skin).
  • Teary eyes.
  • Swollen eyelids.
  • Itchy mouth, swollen lips.
  • Tightness in the throat.
  • Wheezing.
  • Vomiting.
  • Stomach pain.
  • Diarrhoea.

How is a diagnosis of peanut allergy made?

Diagnosis should be made by your doctors after looking into your child’s history and symptoms.

  • Parents may have noticed their child getting sick or developing a rash soon after eating or having contact with peanuts.
  • Special tests that may be done by a specialist doctor include:
    • Allergy skin test.
    • Peanut RAST (Radioallergosorbent test).
    • Peanut challenge (this is rarely done in children).

These tests may differ in different individuals and must be interpreted carefully by a your doctor.

What is anaphylaxis?

Some children can develop a severe allergic reaction termed Anaphylaxis. This is a sudden and serious reaction involving the skin, lungs, gut, heart and blood vessels. After onset, these reactions usually progress rapidly with symptoms including:

  • Sense of fear, impending doom.
  • Flushed face.
  • Swollen eyes, mouth, tongue, lips.
  • Tightness in throat.
  • Difficulty in breathing, wheezing.
  • Nausea and vomiting.
  • Stomach pains.
  • Giddiness.
  • Low blood pressure.
  • Rapid heart beat.

Severe reactions can lead to coma and eventual death if untreated.

How is peanut allergy treated?

For all allergic reactions

  • Seek medical attention as soon as possible.

Medications to treat allergy include:

  • Antihistamines.
  • Adrenaline.
  • Steroids.

You need to consult your doctor for advice on these.

How is anaphylaxis treated?

Anaphylaxis is a medical emergency:

  • You should bring your child to the nearest hospital immediately.
  • EpiPen should be used immediately if you carry one ( EpiPen is a prefilled Epinephrine or Adrenaline auto injector which is available in Malaysia. Consult your doctor on the necessity of obtaining a prefilled adrenaline syringe).

How can this condition be prevented?

To prevent peanut allergy:

  • Mothers with a family history of allergy should avoid nuts during pregnancy.
  • Exclusively breastfeed babies until age 6 months.
  • Do not introduce peanuts to your children until age 3 years.

What should I do if my child has peanut allergy?

If your child has peanut allergy:

  • Avoid all peanuts and also other type of nuts.
  • Read all food labels carefully and avoid those with peanuts.
  • Do not share your child’s food utensils with others.
  • Have an emergency plan of what to do should an allergic reaction happens.
  • Carry an EpiPen (either you or your child to administer in emergencies).
  • Give your child a Medic Alert bracelet to wear.

Are there medications to prevent an allergic attack?

Monoclonal anti-IgE antibodies have been used to reduce the occurrence of peanut allergy. Please consult your doctor about this.

What are the other important things to be aware of?

  • Be aware that many food items may contain peanut which is not stated in their labels.
  • A nutritionist needs to be consulted if you are uncertain of the content of a specific food.
  • When you exclude food items which contain peanut from your child’s diet you need to ensure that your child receives enough nutrients from other food sources.
Last reviewed : 26 April 2012
Content Writer : Dato’ Dr. Lim Nyok Ling
  : Dr. Lim Sern Chin
Reviewer : Dr. Tang Swee Ping