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Peanut allergy

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**1. Peanut Allergy Overview:**

Anaphylaxis may occur with symptoms like itchiness, hives, swelling, eczema, sneezing, and asthma attacks.
– Additional symptoms may include abdominal pain, drop in blood pressure, diarrhea, and cardiac arrest.
– Allergic reactions are due to immune system hypersensitivity, making peanut allergy severe.
– Cross-reactivity with tree nuts, soy, and other legumes is common due to allergenic proteins grouped by families.
– Reviews show 6-40% of individuals with peanut allergy react to tree nuts/legumes.
– Similarity in storage protein structures causes cross-reactivity, with proteins like cupin, prolamin, and profilin playing a role.
Peanut allergy can be caused by oral consumption, with 11 allergenic peanut proteins identified.
– Major allergens trigger immunological responses in over 50% of cases, mediated by IgE antibodies.
– Desensitization through early exposure to peanut proteins can reduce allergic response risks, with the American Academy of Pediatrics rescinding delay recommendations.

**2. Diagnosis and Treatment of Peanut Allergy:**

– Diagnosis starts with medical history and physical examination, with skin prick tests confirming specific food allergies.
– A positive skin prick test is about 50% accurate, and the double-blind placebo-controlled oral food challenge is the gold standard for diagnosis.
– Prevention involves early introduction of peanut foods to infants, with high-risk children needing assessment by an allergy specialist.
– Treatment includes epinephrine autoinjectors for anaphylaxis, antihistamines, and prednisone for accidental ingestion, and strict avoidance of peanuts as the current cure.
– Immunotherapy aims to reduce allergic sensitivity but has risks and is not widely used, with research ongoing on sublingual and epicutaneous immunotherapy.
– Prognosis shows peanut allergies resolve less often in childhood compared to other allergies, with re-evaluation recommended annually for young children and every few years for older children and adults.

**3. Maternal Diet and Peanut Allergy Development:**

– Conflicting evidence exists on the effect of maternal diet on peanut allergy development, with insufficient research on maternal peanut exposure.
– The impact of early consumption of peanuts by children on sensitivity is unclear, with a lack of good studies on maternal diet’s effect on allergy development.
– Research on maternal diet’s impact on peanut allergy is inconclusive, with no definitive recommendations available.

**4. Epidemiology and Society Impact of Peanut Allergy:**

Peanut allergies affect 0.6% of the U.S. population, with a self-reported incidence among U.S. children tripling from 1997 to 2008.
– In England, 4,000 people are newly diagnosed with peanut allergy annually, with the incidence in Western countries ranging from 1.5% to 3%.
Peanut allergy is a common cause of food-related deaths, leading to increased public awareness and impacting the quality of life for children, parents, and caregivers.
– Legislation like the Food Allergen Labeling and Consumer Protection Act affects food packaging, and schools have protocols to prevent allergic reactions, though accidental exposure remains a concern.
– Allergies can lead to bullying and social challenges for affected children.

**5. Labeling and Cross-Contamination Concerns:**

– Some countries have labeling laws for major allergens added intentionally to food products, with the U.S. requiring disclosure of eight major food allergens on packaged labels.
– Labeling laws vary on including trace amounts from cross-contamination, with experts suggesting setting threshold quantities for labeling.
– Precautionary allergen labeling (PAL) warns of possible cross-contamination but can be confusing due to variations in wording and regulations among countries.
– PAL has been replaced by guidance from VITAL 2.0, with efforts to identify the eliciting dose for allergic reactions and improve labeling regulations for unintentional contamination.
– Brazil mandates the declaration of cross-contamination possibility, and the EU is initiating labeling regulations for unintentional contamination.

Peanut allergy (Wikipedia)

Peanut allergy is a type of food allergy to peanuts. It is different from tree nut allergies, because peanuts are legumes and not true nuts. Physical symptoms of allergic reaction can include itchiness, hives, swelling, eczema, sneezing, asthma attack, abdominal pain, drop in blood pressure, diarrhea, and cardiac arrest. Anaphylaxis may occur. Those with a history of asthma are more likely to be severely affected.

Peanut allergy
A peanut allergy warning
SpecialtyEmergency medicine
SymptomsItchiness, hives, swelling, eczema, sneezing, asthma attack, abdominal pain, drop in blood pressure, diarrhea, cardiac arrest
CausesType I hypersensitivity
Risk factorsChildhood in developed countries
Diagnostic methodMedical history and physical examination by an approved doctor
Differential diagnosisTree nut allergy
PreventionProper early introduction to peanuts and their products during pregnancy and infancy
Antihistamines (mild)
Frequency0.6% (US)
1.5–3.0% (Western world)

It is due to a type I hypersensitivity reaction of the immune system in susceptible individuals. The allergy is recognized "as one of the most severe food allergies due to its prevalence, persistency, and potential severity of allergic reaction."

Prevention may be partly achieved through early introduction of peanuts to the diets of pregnant women and babies. It is recommended that babies at high risk be given peanut products in areas where medical care is available as early as 4 months of age. The principal treatment for anaphylaxis is the injection of epinephrine.

In the United States, peanut allergy is present in 0.6% of the population. Among children in the Western world, rates are between 1.5% and 3% and have increased over time. It is a common cause of food-related fatal and near-fatal allergic reactions.

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