Peanut allergy is one of the type I food allergies, which means that symptoms occur immediately after eating it.
What is a peanut allergy?
Peanuts belong to the legume family and are excellent sources of minerals. However, a peanut allergy is one of the most severe food allergies. Even a very small amount can cause an allergic reaction. Then those affected suffer from dizziness, nausea, flushing of the skin or palpitations.
Causes
In an allergy, the body’s defenses are directed against substances that are normally harmless. At first contact, sensitization occurs and the immune system produces antibodies against the allergen. Allergic reactions then occur upon further contact. The triggers for an allergic reaction are so-called Ara-h allergens, which bind to IgE antibodies. This causes the release of inflammatory mediators. The antibodies attach themselves to basophilic granulocytes or mast cells. The next time the cells come into contact with the allergen, they release histamine or other substances. Mast cells are found in all body tissues and are also responsible for allergic reactions. Basophilic granulocytes belong to the white blood cells. As soon as the allergen enters the circulation, the granulocytes react, which mainly affects the blood vessels. For a severe reaction, even the ingestion of a small amount of peanuts is sufficient; in some cases, even skin contact is enough to cause a rash. Allergies are often genetically determined. So if one parent suffers from a peanut allergy, it is possible that it will also occur in the child. The danger is even greater if both parents are allergic. Another cause is exaggerated hygiene, as the immune system is thus underchallenged and looks for another target.
Symptoms, complaints and signs
Peanut allergy causes symptoms in the digestive system, respiratory tract, skin, or even cardiovascular system. Common symptoms include restlessness, feelings of panic, watery eyes, and swelling of the mucous membranes in the throat or mouth. But also a slowed or accelerated pulse, headache or clouding of consciousness can occur in connection with a peanut allergy. It is also often manifested by frequent sneezing, nasal congestion and coughing, asthma attacks and whistling breathing. In addition, nausea, abdominal cramps and diarrhea may occur. Redness, wheals or eczema form on the skin, and in the worst cases, peanut allergy leads to anaphylactic shock. Anaphylaxis is life-threatening, so in the event of anaphylactic shock, the emergency physician must be informed immediately. To avoid possible circulatory collapse, it is important to keep your legs elevated until the doctor arrives.
Diagnosis
Within the framework of an anamnesis, the doctor first informs himself about the patient’s dietary habits, allergies within the family, the mental state of the affected person or any previous illnesses. In order to determine an allergy, the so-called prick test is very often carried out, in which potential allergens are applied to the skin. If allergic reactions appear after about thirty minutes, a potential allergen is present. Another diagnostic option is a blood test, in which the total concentration of antibodies in the blood is examined. These antibodies are responsible for triggering an allergic reaction. In the provocation test, the physician administers the allergens intranasally or orally to the test person, but very severe reactions can occur here, so that this test should never be performed on one’s own. In some cases, the rub test is also used, in which the allergen is rubbed on the skin to then determine any reactions.
Complications
Various complications can occur with a peanut allergy. These occur mainly directly after eating the peanuts and are therefore immediately detectable. The complications are very diverse and can affect the lungs, eyes and digestion. Usually there are watery eyes, a rising panic and swelling in the mouth. Usually these symptoms are accompanied by headaches and dizziness. If a large amount of peanuts has been ingested, peanut allergy can also lead to shock.In this case, treatment by the doctor is necessary. In the case of mild allergies, the symptoms usually disappear on their own. Swelling should also be examined by a doctor. Due to the peanut allergy, the patient’s diet is restricted, so that he is no longer allowed to eat peanuts. However, this only affects a small fraction of the possible foods available to the patient. If a peanut allergy does occur, it can be treated with the help of medication. The symptoms disappear completely after a few hours without further complications. If the peanut allergy occurs for the first time, education by a doctor is necessary. The patient should also be tested for other allergies and intolerances to avoid complications. These include, first and foremost, other legumes.
When should one go to the doctor?
Even at the first suspicion of a peanut allergy, those affected should see a doctor, preferably an allergist, because in some people even small amounts of peanuts are enough to trigger severe allergic reactions such as anaphylactic shock. Since peanut components are also present in many products where one would not suspect them at first glance, it is important that these people are informed by the doctor about the allergy and its risks and are given an emergency kit with an antihistamine, cortisone and adrenaline, which they must always carry with them so that they can react quickly in an emergency. Since some people react to different allergens, a prick test is carried out, and if necessary also a blood test, since a combination of allergies increases the risk of possible complications. At the doctor’s office, affected people are also given comprehensive information about foods that contain peanuts or traces of them, and they usually receive additional nutritional counseling from trained professionals, since the treatment of a peanut allergy largely consists of avoiding the allergen in daily life, and informing other people about the allergy in situations that may promote an allergic reaction. The doctor also informs family members what to do in an emergency.
Treatment and therapy
An allergy to peanuts cannot be cured, however, there are various measures to live with this condition. Basically, a renunciation of peanuts or products in which they are contained is necessary. This is not always easy, because many foods and cosmetics contain traces of peanuts. Special caution is also required with adhesives, bath oils, soaps, vitamin preparations or linoleum. Under medical treatment, those affected are also given glucocorticoids as well as antihistamines. Nutritional therapy with an appropriate specialist is also recommended. It is important that those affected or their relatives are well informed so that the first symptoms can be recognized quickly. Peanuts belong to the legumes. Some peanut allergy sufferers are therefore also allergic to beans or soy or to tree nuts such as pistachios, almonds or hazelnuts.
Outlook and prognosis
Peanut allergy, like most allergies, is not curable. As with almost all allergies to foods, “allergy vaccination” is also not an option. Desensitization does not improve peanut allergy. The patient will therefore have a lifelong allergic reaction to peanuts and must exercise caution, because peanut allergens are among the substances that can cause particularly severe symptoms, including dangerous anaphylactic shock with fatal consequences. However, it is possible that the peanut allergy changes in the course of life – usually the affected person reacts even more violently to contact with peanuts than before. Often the peanut allergy turns out to be very severe anyway, so that sufferers can expect severe symptoms if they eat peanuts. If they do not have an Epi-Pen with them and come into contact with peanuts, severe reactions can end in the death of the patient if no one is able to help them in time. Furthermore, in the course of life, cross-allergies can develop which occur together with peanut allergy – this does not have to happen, but it is also not possible to predict a time or to name factors which favor the development of cross-allergies.This makes it all the more important for sufferers to know the most common cross-allergies associated with their peanut allergy so that they would recognize symptoms quickly.
Prevention
An allergic reaction to peanuts can be prevented by avoiding products that contain peanuts. These include, for example, cornflakes, salty cookies, muesli, chocolate bars or deep-fried products. But cold-pressed oils can also contain peanut residues. Refined oils are usually well tolerated and pumpkin seeds are also a very good alternative in the case of a peanut allergy. Since 2005, foods containing peanuts must be labeled accordingly. Therefore, sufferers should read the fine print on packages carefully, and it is also advisable to always carry an emergency kit containing syringes containing cortisone, adrenaline and an antihistamine. Loose goods from the bakery, however, are exempt from this allergen labeling regulation, so you have to rely on the information of the seller. Preference should be given to organic products, as these contain fewer additives. On the Internet, you can also find their own stores that offer products for peanut allergy sufferers.
Aftercare
Often, a peanut allergy is diagnosed in childhood. Otherwise, this diagnosis occurs due to anaphylactic shock after eating a peanut. Since peanuts pose acute danger to the life of a peanut allergy sufferer, prevention is far more important than follow-up. High risks for peanut allergy exist in children who have numerous skin eczemas and are also allergic to chicken eggs. However, peanut products should not be given to such children unless they already have a peanut allergy. After anaphylactic shock from peanuts in childhood, the precautionary measures are also aftercare measures. After acute treatment, the family is advised to strictly avoid foods containing peanuts and provided with an emergency kit. This may include medications such as antihistamines, Jext-Anapen, Infectodexa croup, and salbutamol with a breathing mask. These preparations can be life-saving in the event of accidental ingestion of peanut-containing products. Follow-up care consists mainly in the care of parents and raising awareness of the social environment about this problem. Children cannot yet take care of themselves.
This is what you can do yourself
People affected by a peanut allergy have no concrete means of counteracting the effects of their allergy in everyday life with everyday remedies. This is limited to carrying an emergency kit and avoiding the allergen. However, it is possible for those affected to communicate their own needs to the environment in a targeted manner and to gain added value from avoidance behavior with regard to food. It is important for affected persons to communicate that they must avoid the allergen at all costs in situations where they might come into contact with it. It should not be in the vicinity. If this is met with incomprehension or even resistance, it can be remedied by means of a simple explanation (also with the aid of the emergency kit). Communication with friends, relatives and, if necessary, the employer, facilitates safe movement in an environment full of food. Avoiding many products that may contain traces of peanuts also has positive benefits. For example, the affected person should feel encouraged to try new foods from time to time. Moreover, by acquiring a broad knowledge of risky and low-risk foods along the way, he or she will be able to make increasingly quicker and better decisions about what to eat.
