Peanut allergy

peanuts

Type I allergic reaction

Peanut plant

A peanut allergy is a food allergy of type I (immediate type). This means that the symptoms appear immediately after or when you eat peanuts , but no later than two hours. Later reactions are very rarely reported.

Compared to other foods , peanuts in particular have a very high allergic potential. The reason for this is that peanuts have a wide variety of allergens .

Symptoms of a peanut allergy can show up on contact with very small traces (in the range of a few milligrams) of the allergen. In the case of particularly severe forms of this allergy, skin contact or inhalation is sufficient, as can be done, for example, in an airplane via the air conditioning.

Even babies can be affected by a peanut allergy. In this particular case, the allergen is transmitted through breast milk after the mother consumes peanuts.

Since the basic treatment options for a peanut allergy are quite limited, this disease usually represents a very deep intervention in the normal lifestyle of the person affected.

Within the group of allergies, peanut allergy is one of the main causes of allergy-related deaths.

causes

An allergy is basically a malfunction of the immune system . For various reasons, the body's defenses can suddenly turn against actually harmless substances. The first contact with the allergen leads to a so-called sensitization . This means that the immune system makes antibodies against the allergen. A second contact then leads to allergic reactions.

There are many causes of a peanut allergy. Scientific studies have shown that this type of allergy can have genetic causes. If one of the parents is already allergic, the child is at a much higher risk of developing an allergy. If both parents are allergic, this probability is already at 60%. Basically, however, there is the potential for every person to develop an allergy.

Another cause for the outbreak of an allergy is described by the hygiene hypothesis . It is assumed here that the immune systems of people in western countries are chronically under-challenged by excessive hygiene. This leads to the fact that the immune system is now looking for other targets. In this case, this can also be the actually harmless peanut.

Symptoms

The symptoms of a peanut allergy affect the respiratory tract , digestive system , skin and, in severe cases, the cardiovascular system . These symptoms include:

General symptoms:

• Watery eyes
• Restlessness
• Fear - and panic
• Swelling of the lining of the mouth and throat
• a headache
• Accelerated or slowed pulse
• Clouding of consciousness. Also unconsciousness.
• Loss of urine and / or stool (only in very severe cases, for example in anaphylactic shock )
• Itching and swelling of the ear canal

On the airways:

• Itching in the nose
• Frequent sneezing
• Stuffy nose or runny nose
• Tightness in the throat
• whistling breathing
• Asthma attacks
• to cough
• Laryngeal edema

On the digestive system:

• Nausea and / or vomiting
• diarrhea
• Stomach cramps

On the skin:

• Redness
• Wheal formation
• Hives
• Eczema formation
• Eczema worsening
• itching

On the cardiovascular system

• anaphylactic shock

Since the disease takes an acute course in most of all cases, chronic consequences are very rare.

diagnosis

The diagnosis of a peanut allergy takes place with the following measures: First of all, the anamnesis is on the plan. During this interview, the attending physician asks about the patient's individual circumstances. Particular emphasis is placed on individual eating habits, any previous illnesses, allergies in the family and also psychological factors. It is advisable to bring an allergy diary with you to this interview.

Another very frequently used diagnostic method is the prick test . Here the potential allergens, which are contained in clearly defined solutions, are applied to the skin. The test solution is then applied to the upper layers of the skin using a lancet . If, after 20 to 30 minutes, allergic reactions in the form of redness or wheals appear at the puncture sites , at least one potential allergen has been identified.

There is also the possibility of blood tests. This examines the presence or total concentration of special antibodies in the blood. These antibodies are called immunoglobulins . In most of all cases, the immunoglobulin E (IgE) is responsible for the allergic reactions.

The last option is the provocation test. The allergens in question are administered to the test person. This type of test is done either orally or intranasally if you have a peanut allergy . Since these tests can lead to severe reactions, such as anaphylactic shock, you should never do these tests yourself. The presence of a doctor is essential. In particularly severe cases of peanut allergy, these tests are also carried out under clinical conditions.

The friction test is used for particularly sensitive people. In this case, the potential allergen is only rubbed superficially onto the skin. Any reactions are then determined.

therapy

There is no cure for a peanut allergy. However, there are some measures that enable allergy sufferers to deal with their illness in everyday life. Likewise, peanut allergy sufferers only rarely lose their allergy on their own, as is possible with some other forms of allergy.

Parental leave, i.e. the complete renunciation of peanuts or products made from them (and also products to which those affected react in the context of a cross-allergy ) is fundamentally necessary. This is not easy in everyday life, as many food products, but also cosmetics, contain peanuts or traces of the same.

Studies are currently taking place that investigate another possibility of therapy using desensitization . In this study, tiny traces of peanuts are administered to the patient. In very severe forms of peanut allergy, these are in the form of solutions that contain peanut proteins in the range of a few milligrams. This dose is increased until the patient should be able to tolerate about a peanut. Although this does not allow it to be consumed regularly, it is hoped that this will prevent an allergic reaction in the event of accidental ingestion of trace amounts.

Modified (immunologically optimized) capsid shells of the cucumber mosaic virus ( Cucumber Mosaic Virus - derived VLPs , CuMVtt) are an approach for a possible vaccination against peanut allergy.

prevention

Avoiding contact with peanuts in everyday life can be very difficult, as peanuts can also be found where you would not suspect them at first glance. Here is a selection of products that contain peanuts or traces of them: Chocolate bars, pies and cakes, edible oils, cornflakes, muesli, ice cream, various ready meals, savory biscuits, potato chips, personal care products containing peanut oil, wax crayons and fried foods. This list is only for the purpose of illustration and is far from complete.

Since 2005, food manufacturers have been legally obliged to label foodstuffs that may contain peanuts. Therefore, as an allergy sufferer, you should always read the small print on the sales packaging very carefully. The note “May contain traces of peanuts” should make allergy sufferers sit up and take notice.

If an allergy to peanuts is known, the doctor will give the patient a so-called emergency kit on the way. This contains pre-filled syringes. One with adrenaline , one with cortisone, and a fast-acting antihistamine . All people around the allergy sufferer should be able to use this emergency kit.

Dogs are also trained by some dog schools to track down foods that contain peanuts or traces that these dogs should then display. This is a safe method for those affected to avoid contact with "invisible" peanut traces, especially with regard to "invisible" peanut traces, as dogs' sense of smell is very good.

Web links

• Entry on peanut allergy in Pharmawiki

Individual evidence

1. ↑ Entry on peanut allergy in Pharmawiki , accessed on January 28, 2017. - Allergy type I
2. ^ Association of Allergologists Brandenburg EV: Peanut allergy - even the smallest traces are enough to cause the symptoms to break out
3. ^ Medical Association of German Allergologists EV: Peanut allergy
4. ↑ Entry on peanut allergy in Pharmawiki , accessed on January 28, 2017. - Causes
5. ↑ Symptoms of a peanut allergy ( Memento of the original from May 19, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. on Onmeda.de  
6. ↑ Daab.de: Peanut allergy - diagnosis
7. ^ Therapy for a peanut allergy
8. ↑ Martin F. Bachmann, Federico Storni et al : Vaccine against peanut allergy based on engineered virus-like particles displaying single major peanut allergens , in: Journal of Allergy and Clinical Immunology, Volume 145, No. 4, April 2020, p. 1240 –1253.e3, doi: org / 10.1016 / j.jaci.2019.12.007 , abstract
9. ↑ Harald Lesch: Kuhstallpille & Co - The allergy code cracked? , §How can allergies be stopped ?, broadcast by ZDF on May 26, 2020
10. ↑ Children's Clinic, University of Lübeck: Peanut allergy diagnosis and use of the emergency kit
11. ↑ WDR.de: Prevent a peanut allergy
12. ↑ personal-dog-training.net ( memento of the original from December 7, 2015 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. : Offer (maintrailing) from Liane Vogel (state approved dog trainer; dog school) 
13. ↑ Sabine Jossé: Peanut allergy: How do peanut sniffer dogs warn of the allergen? . In: www.mein-allergie-portal.com . On: May 6, 2015. Accessed: October 16, 2015.
14. ↑ Galileo episode on October 16, 2015 ( from 7:04 p.m. to 8:14 p.m. on ProSieben )

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !