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Indian Pediatr 2016;53: 746 |
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Tragic Outcome of Peanut Allergy
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Ewa Willak-Janc and *Hanna Sikorska-Szaflik
1st Department and Clinic of Paediatrics, Allergology
and Cardiology, Wroclaw Medical University, ul. Chalubińskiego 2a 50-368
Wroclaw, Poland.
Email: [email protected]
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Peanut and tree nut allergies are responsible for 80% out of 100-200
lethal cases of food allergy [1]. Children with food allergies have a
lower quality of life caused by fear of a possible anaphylaxis [2,3].
We report a case of 9-year-old girl with positive
family history of atopic diseases. Her first acute allergic reaction
with dyspnea and vomiting occurred at the age of two years. At that
time, she was hospitalized, treated with intravenous steroids, and was
diagnosed with allergies to cow’s milk, chicken egg and peanuts. Due to
food allergies and frequent respiratory tract infections, her parents
decided not to send her to a kindergarten. When the girl was 5-year-old,
allergy tests did not confirm allergies to cow’s milk and chicken egg
anymore; however, specific IgE against peanuts were still present in
high titers. One year later, she started attending an organized
pre-school learning. She used to eat home-made meals only. At the age of
nine years, she participated in the school camp – her first fully
independent trip. She was equipped with an adrenaline auto-injector. The
girl was educated and aware of her illness, and she avoided consuming
peanuts. Despite that, once at home, she ate three pieces of chocolate
labelled with a warning ’may contain peanuts’. After a few minutes, she
developed stomach ache and dyspnea. Her father immediately administered
her 0.15 mg of adrenaline intramuscularly, but she lost consciousness.
Her neighbour, who was a paramedic, administered another dose of 0.15 mg
of adrenalin from auto-injector and started resuscitation. The ambulance
and emergency helicopter arrived within a few minutes. The child was
intubated, chest compressions were carried out, and adrenaline,
hydrocortisone and calcium chloride were administered intravenously. The
girl regained consciousness for a short period of time. However, while
she was being transported to the hospital, she again went into a cardiac
arrest and despite 2.5 hour long resuscitation, she died. The postmortem
report suggested anaphylaxis as the cause of her death.
Despite continuous improvement in diagnostic methods,
the most important factors for patients with food allergies are more
legible information on food packaging, strict diet and proximity of
professional medical help. It is essential to educate patients about
their allergy and equip them with adrenaline auto-injector. 3E
(education, elimination, epinephrine) should be the first line of
defense from a tragic results of anaphylaxis.
Contributors: Both authors were involved in
acquisition of information, drafting the manuscript, and its final
approval.
Funding: None; Competing interest: None
stated.
References
1. Wang J, Sampson HA. Food allergy: Recent advances
in pathophysiology and treatment. Allergy Asthma Immunol Res.
2009;1:19-29.
2. Marklund B, Staffan A, Nordström G. Health-related
quality of life in food hypersensitive schoolchildren and their
families: Parents’ perceptions. Health Qual Life Out. 2006;4:48.
3. Sicherer SH, Noone SA, Munoz-Furlong A. The impact of childhood
food allergy on quality of life. Ann Allergy Asthma Immunol.
2001;87:461-4.
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