Allergy to peanuts and / or nuts

Allergy to peanuts and / or nuts

What is an allergy to peanuts and / or nuts?

In the case of a food allergy, the immune system reacts abnormally after eating a certain food. In the case of a peanut and / or nut allergy, such a reaction occurs after eating a food that contains (traces of) proteins from peanuts and / or nuts. A combined allergy to peanuts and nuts is common. A peanut is not a nut, but a legume, just like a pea or a soy bean. Allergies to peanuts and nuts are becoming more common and starting at an increasingly younger age. 

The most common food allergies in children are still cow’s milk allergy and chicken egg allergy.

A child can be allergic to various foods and sometimes to multiple foods at the same time. The way the allergy expresses itself does not depend on the food.

Symptoms allergy to peanuts and / or nuts

A food allergy develops in two steps. First, after contact with a certain food, the immune system makes special allergic antibodies against this. It is not known why the immune system does this and why it is specifically against certain food components. At this stage a patient has no noticeable symptoms.
Once these allergic antibodies have been prepared, it is possible that an allergic reaction may occur during a subsequent contact with this food. In the case of a peanut or nut allergy, this reaction can manifest itself in various ways. The complaints can arise quickly. With each subsequent contact with peanut or nut, the symptoms can be more severe. An allergy to nut or peanut can also manifest itself in eczema. You can read more about eczema in the folder constitutional eczema.
Typical of an allergic reaction can be:
  • red face
  • warm feeling
  • itching around or in the mouth
  • itching of palms or soles of feet
  • watery eyes, sneezing and / or a runny nose
  • swelling of tongue, lips and eyelids
  • difficulty swallowing and talking due to swelling of the tongue and throat
  • nausea, vomiting, abdominal pain and diarrhea
  • shortness of breath with squeaking, an asthma attack
  • dizziness, tendency to faint and ultimately unconsciousness
Usually combinations of these phenomena occur.
Anaphylaxis is the most extreme and dangerous form of an allergic reaction; the whole body is involved. In such a case it is important that immediate medical assistance is provided, call 112!
With rapid medical care, the patient can heal without permanent damage.

How does an allergy to peanuts and / or nuts arise?

The allergic reaction occurs after contact with peanuts or nuts. This can be after eating or sometimes already through skin contact with it. A trace of peanut butter on the skin, for example, can even cause severe allergic reactions in extreme cases. The immune system, construction and triggering factors play a role in the development of this reaction.
The immune system In most children the proteins from peanuts and nuts do not cause any complaints. In a number of allergic children, however, the immune system responds to such a protein by making antibodies. The child does not notice this. The next time the immune system comes into contact with the food protein (this is called allergen), it is recognized and linked to the antibodies. This coupling causes the immune cell to which the antibodies are attached, the so-called mast cell, to break open. The content of these mast cells, mainly histamine, ends up in the blood and in the mucous membranes of the lungs, nose and intestines. Histamine is the most important substance that is responsible for the symptoms that can occur with peanut and nut allergies.
It is usually not possible to trace how and when the body first came in contact with a certain allergen. Then it seems as if a reaction already occurs with the first contact. Very small amounts of food components are probably passed on from mother to child through breast milk.
Aspiration Genetic predisposition plays an important role in food allergies. This is called atopic constitution. In addition to food allergies, these children may also be confronted with allergic nose complaints, hay fever, asthma and eczema (constitutional eczema or dewworm). If a child has a father and / or mother and / or an older brother or sister with food allergies or asthma, it is more likely that this child will also have an atopic constitution at birth. This chance increases as more family members have (had) such complaints.
Inducing factors Not every child with an atopic constitution suffers from a food allergy. It is not entirely clear why certain foods lead to allergies more often than others. We do know, however, that exposure to high-risk foods such as nuts, peanut, but also fish and shellfish at a very young age offers a greater chance of causing allergies in sensitive (atopic) children.
More and more people suffer from an allergy to nuts and / or peanuts. It is not clear why it occurs more often. Factors that could play a role are:
  • Allergies in themselves are becoming more common, including peanut and / or nut allergies
  • traces of peanut and / or nut protein occur in more and more products
  • the protein constituents of nuts and peanuts are easily seen by the body as allergen. None of these assumptions has been scientifically proven.

Is it serious and what can you expect?

Being allergic to peanuts and / or nuts is very difficult and can sometimes even be serious.
Severe allergic reaction The allergic reaction that occurs is unpredictable and can also become more severe over time. This is partly dependent on the amount of allergenic food that is (accidentally) eaten. Anaphylactic reactions can be treated quickly ( 112 calls! ) Without permanent damage. Sometimes, however, an anaphylactic reaction is fatal.
Lifelong dieting Traces of peanuts and / or nuts are present in many foods. People with an allergy to peanuts and / or nuts have to be very critical about their food throughout their lives. Cosmetic products can also sometimes contain such proteins. In contrast to many other allergies, peanut and / or nut allergy appears to persist throughout life. You should also never test whether you or your child still have an allergy, as this can result in a life-threatening allergic reaction! This requires further allergic examinations and guidance by a qualified physician.
Cross allergies Many people with a peanut allergy are also allergic to nuts, and vice versa. As previously reported, a peanut is a legume, just like soy and pea. Various nuts such as hazelnut, almond and walnut are also mutually related. An accumulated allergy to the one can also cause symptoms with a food that is related to this. To avoid confusion and because you never know for sure whether there are no traces of peanuts between the nuts in the factory or in the store, and vice versa, it is usually advised to avoid nuts and peanuts. Traces of peanut and nut are very often hidden in chocolate, chocolates, cookies, but also in (bagged) sauce and so on.
Special branded product lists can be ordered at the Voedingscentrum, which lists nut and peanut-free products.
Expectations for the future Scientists are trying to develop a vaccine that makes allergic people more tolerant of the proteins from peanuts and / or nuts. Unfortunately, this has not yet been achieved.

When to the doctor?

As soon as you suspect that you or your child is allergic to peanuts and / or nuts, it is advisable to contact your doctor. Based on a number of examinations, the doctor or specialist can determine whether there is indeed an allergy to peanuts or nuts. You then have certainty. If it appears that there is no allergy, you or your child do not have to follow a diet. If there is an allergy, you can prevent serious reactions by handling food critically.
If necessary, you or your child will receive medication to be used for any subsequent allergic reaction. These can be tablets that counteract the action of histamine in mild reactions, or an injection pen with adrenaline. Adrenaline counteracts the effects of the anaphylactic reaction in the body. The doctor will teach you how and when to administer this injection to yourself or your child in an emergency. After using such an adrenaline pen you should always consult a doctor immediately.

What can you do about it yourself?

You cannot do anything to make a peanut and / or nut allergy disappear. You can, however, try to prevent an allergic reaction by dealing critically with food and cosmetics. Informing your environment or that of your child can prevent misunderstandings and accidents. Should a reaction nevertheless occur, you can limit its symptoms by administering emergency medication.
Critical handling of food and cosmetics Very many foods contain (traces of) peanut and nut protein. Also foods that you do not expect immediately, such as spice mixes, curry, cake, soup and vitamin preparations. Certain cosmetics also contain oils that contain peanut or nut protein. On most products you can read on the label whether or not it contains traces of peanuts and nuts. Unfortunately, there are still products with incorrect, incomplete or no reports at all. You can request label aids and lists from your doctor, dietician or the Food Allergy Foundation to help you choose safe foods. 
At the Voedingscentrum you can order a brand article list for products that are free of various allergenic food components. It is important that you regularly check whether the lists have been adjusted or updated. This way you stay up to date. However, you will never receive one hundred percent certainty. That is why it is important that you or your child always have emergency medication with them.
Keep emergency medication within reach Anaphylactic reactions can be broken with medication. The doctor will prescribe the medicine that best suits your situation. You or your child will usually be prescribed an adrenaline pen. This is a syringe in the form of a pen that you can easily use yourself. The pen contains the substance adrenaline that counteracts the symptoms of the anaphylactic reaction. 
The moment you suspect that you or your child have an anaphylactic reaction, you give the injection. It is better to use the pen too early than too late. If your child is allergic and goes to others or to school, give the adrenaline pen to the caregivers or the teacher. When the child is old enough, he can carry the pen himself. It may be useful to wear an SOS medallion or a medical alert bracelet.
Inform the environment Especially with allergic children it is important that you inform the environment. For example, a child who is allergic to peanut may already get a reaction when touched by a child who has just eaten peanut butter. It is important that your child’s teacher is aware of the dangers, severity and symptoms of an allergic reaction. Also explain to the teacher how to use the adrenaline pen and make sure that the teacher always has one pen available. In addition, it is also good to tell your child’s classmates and friends what is going on. For example, you can explain that they should never trade food and that they should always wash their hands after eating before they come in contact with your child.
Contact with fellow sufferers You can go to the Food Allergy Foundation for information, practical tips and contact with fellow patients.

General advice and precautions

Children with an increased risk of developing allergies, children with an atopic tendency, should not be able to ingest peanut and nut protein until the third year of life. So for example no peanut butter or hazelnut paste.
Source : dokterdokter

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