Table of Contents
Acknowledgments 10
Foreword 12
Preface to the third edition 14
Introduction 17
Chapter 1 Allergies in a Nutshell
What are food allergies? 19
How are food allergies related to the immune system? 21
How do you know whether you have a food allergy? 24
How do I choose an allergist? 25
What information does your doctor need to diagnose food allergies? 27
What are the different kinds of allergy tests and how do they work? 29
What is a specific IgE test? 30
Can allergy tests predict the severity of a reaction? 32
How accurate are allergy rests? 33
What are component-resolved diagnostic tests and are they more accurate than skin tests and specific IgE tests? 33
If I can eat peanuts without any problems, even though my peanut allergy tests are positive, should I stop eating them? 35
What is a food challenge? 35
What is the youngest age to undergo a food challenge? 38
What is an elimination diet? 39
Are there food reactions that aren't allergies? 41
Chapter 2 Peanut Allergy 101
What is the historical background of peanut allergy? 43
What is the history of peanut allergy in medicine? 44
How common is peanut allergy? 46
Why have peanut allergy and other allergic diseases increased so dramatically, particularly in young children? 48
What is the hygiene hypothesis and how is it related to peanut allergy? 48
Why is peanut allergy more common in the United States, United Kingdom, and Australia compared to the rest of Europe, Asia, and the Middle East? 49
How does tolerance to foods develop? 51
What are the reasons for loss of food tolerance? 52
Does early avoidance of peanut prevent or result in peanut allergy? 53
Is peanut allergy hereditary? 54
Should the sibling of a child with peanut allergy avoid peanuts? 55
At how early an age can peanut sensitization occur? 55
What is it in peanuts that make them so allergenic? 58
Is the peanut a true nut? 59
Are there nuts that do not commonly cause allergies? 61
Should you avoid all members of a food family if you are allergic to one food in that family? 61
Are peanut-allergic individuals also allergic to tree nuts? 64
Should peanut-allergic individuals avoid tree nuts? 64
Should peanut- and nut-allergic individuals avoid seeds? 64
Does soy formula cause peanut allergy in infants? 65
Can peanut protein be found in breast milk? 65
Can peanut allergy be transferred from person to person? 66
Can peanut allergy be cured by organ transplantation? 67
Will I outgrow my peanut allergy? 68
When should children undergo a peanut challenge to see whether they've outgrown their allergy? 71
Can a food challenge be wrong? 72
Is there a chance that after I outgrow my peanut allergy, the peanut allergy may come back? 72
Can allergies to tree nuts be outgrown? 73
Chapter 3 What You Need to Know about Anaphylaxis
What is anaphylaxis? 74
Is anaphylaxis always accompanied by skin symptoms? 77
What is biphasic anaphylaxis? 77
Can severe anaphylaxis be predicted? 79
What are the risk factors for fatal anaphylaxis? 80
What is the treatment for anaphylaxis? 81
Do all ambulances curry epinephrine? 84
When should antihistamines be used to treat anaphylaxis? 84
Should I use my asthma inhaler if I wheeze from an allergic reaction to food? 85
What is the EpiPen? 87
What is the correct dose of epinephrine to use? 88
How often can the epinephrine dose be repeated? 90
Would giving epinephrine unnecessarily cause harm? 91
What is the best way to store an EpiPen? 91
Is an expired EpiPen effective in treating anaphylaxis? 92
What is the newest form of the epinephrine autoinjector and how is it different from an EpiPen? 92
Can epinephrine be given in any other form besides injection? 93
Chapter 4 What Types of Allergic Reactions Result from Peanut Exposures?
What is the smallest amount of peanut that can cause an allergic reaction? 94
What is "airborne" peanut allergy? 96
Does having severe peanut allergy mean I will react to peanut vapor? 97
Can the odor of peanuts cause an allergic reaction? 97
What are the risks associated with the different types of airborne exposures? 101
Can skin contact cause anaphylaxis? 102
Can kissing cause anaphylaxis? 102
Chapter 5 Finding the Hidden Peanut Products
How can peanuts and peanut products be hidden in foods? 104
Why aren't labels foolproof? 109
Should I avoid foods with labels that state "may contain traces of peanut" or "manufactured in a facility that processes peanuts and nuts"? 110
What is the Food Allergen Labeling and Consumer Protection Act? 111
Is peanut oil safe for peanut-allergic individuals? 112
Chapter 6 Keeping Safe in a Peanut-Filled World
Should peanut snacks be banned from airlines? 114
What are some of the problems facing peanut-allergic infants and toddlers? 119
How do I keep my peanut-allergic child safe at school? 121
Why does every student with food allergies need an individual health care plan (IHP)? 123
What is a 504 plan and when should a peanut-allergic student have one in addition to an IHP? 124
Are there formal guidelines on food-allergy management for schools to follow? 124
What is the Food Allergy and Anaphylaxis Management Act (FAAMA)? 125
What is the School Access to Emergency Epinephrine Act? 125
Should peanuts be banned from schools? 126
How do I keep my peanut-allergic child safe on the school bus? 128
What are the most effective cleaning techniques for removal of peanut allergen? 129
What is the responsibility of the school to your peanut-allergic child? 130
What can parents of peanut-allergic children do to help keep the school environment safe for their children? 134
How will this allergy affect my child's emotional and social development? 138
What are some of the problems unique to the peanut-allergic adolescent? 142
Should you wear a Medic-Alert bracelet? 144
Chapter 7 Prevention of Peanut and Other Food Allergies
Should you avoid consuming peanuts and other allergenic foods during pregnancy? 146
Is breast-feeding helpful in preventing food allergies? 148
Is hypoallergenic formula safer than breast milk? 149
Can feeding with hypoallergenic formula prevent food allergies? 150
At what age should peanuts and tree nuts be introduced into a child's diet? 150
Is early introduction of peanuts and tree nuts into an infant's diet beneficial or harmful? 151
What are the LEAP and EAT studies and what questions about a child's diet will they answer? 152
What is a reasonable schedule for the introduction of foods into the diet of a potentially food-allergic infant? 153
Chapter 8 The Future of Peanut Allergy Treatment
Can peanut allergy be treated with allergy shots? 155
What is oral immunotherapy for food allergy? 157
What are the short-term and long-term risks of peanut oral immunotherapy? 158
Are the benefits of oral immunotherapy permanent? 158
What changes in the immune system result from oral immunotherapy? 159
What is sublingual immunotherapy for peanut allergy? 159
What is epicutaneous immunotherapy for peanut allergy? 160
Ts Chinese herbal medicine helpful in treating food allergy? 161
What does the future hold for the treatment of peanut allergy? 162
Appendix A Where Can I Learn More About Food Allergies? 187
Appendix B What Are the Main Take-Home Points to Remember About Peanut Allergy? 170
Appendix C Glossary 173
Appendix D References 179
About the Author 189
Index 190