Mango Allergy: Symptoms, Causes, Diagnosis, Treatment
What Are The Symptoms Of A Peanut Allergy?
Medically reviewed by Jurairat J. Molina, MD
Peanut allergies are a major cause of severe symptoms in children and adults. Even a tiny amount of peanut protein can set off a severe reaction in allergic individuals.
The prevalence of peanut allergies has tripled over the last two decades, with as many as 2.5% of children having a confirmed peanut allergy. Even if you or your child experiences only mild symptoms after eating peanuts, it's essential to contact your healthcare provider for proper diagnosis and treatment.
This article discusses everything you need to know about peanut allergies, including causes, symptoms, and prevention.
Who's at Risk of Peanut Allergy Symptoms and Why?Children with an egg allergy, moderate-to-severe atopic dermatitis (eczema), and/or an immediate family member with a peanut allergy are at the highest risk for developing a peanut allergy. Those with mild-to-moderate atopic dermatitis and no existing food allergies are at moderate risk.
This is because atopic dermatitis causes cracks in the skin barrier, allowing bacteria and allergens to penetrate the skin. When cracked skin comes into contact with peanuts or other allergens, its immune cells may overreact, triggering an allergic reaction.
Some children go on to develop asthma or allergic rhinitis. The progression from atopic dermatitis to later developing food allergies, asthma, and allergic rhinitis is called the allergic march.
When Do Peanut Allergies Start?Peanut allergies generally start in childhood. However, they can develop at any time. One study found that 1 in 6 adults with a peanut allergy experienced their first reaction in adulthood, suggesting that more adults are developing peanut allergies than previously believed.
In adults, peanut allergies are more common among:
Females
Adults with a higher household income
People with atopic dermatitis, asthma, and environmental allergies
Unlike milk or egg allergies, which children often grow out of, peanut allergies are usually lifelong. Only 20% of children will outgrow their peanut allergy over time.
Common Peanut Allergy SymptomsPeanut allergy symptoms generally occur within minutes but may take up to two hours to develop. In rare cases, the reaction may be delayed as long as six hours.
Reactions vary and can range from mild to severe. A person may not always experience the same response. Even if peanuts usually cause only mild reactions, they can potentially lead to more severe symptoms in the future.
Mild SignsMild reactions typically only affect one part of your body and may include:
A few hives, a mild rash or itch
Itchy mouth
Mild nausea or abdominal discomfort
Sneezing or an itchy, runny nose
Compared to other food allergies, peanut allergies are more likely to result in severe allergic reactions and anaphylaxis due to accidental exposure.
Severe, Life-Threatening ReactionsSevere reactions can quickly progress to a severe, life-threatening reaction called anaphylaxis. Symptoms of anaphylaxis often involve multiple body systems at the same time, which can include:
Severe reactions should be treated immediately with an epinephrine injection, best administered with an autoinjector.
When to Seek Emergency CareSeek emergency medical care at the first signs of anaphylaxis, even after administering epinephrine. A second anaphylactic reaction (biphasic reaction) can happen up to 12 hours after the first reaction. Although rates of death caused by anaphylaxis from peanuts are low, it is one of the most common food allergens to result in death.
What to Do for a Mild ReactionIf you are experiencing a few hives, sneezing, mild itching, or nausea after consuming peanuts, your healthcare provider may prescribe or recommend over-the-counter (OTC) antihistamines such as Benadryl (diphenhydramine) or Zyrtec (cetirizine).
Antihistamines block or reduce chemicals your body releases when you encounter an allergen. However, antihistamines will not treat a severe reaction or anaphylaxis and should never be used instead of epinephrine.
What Causes a Peanut Allergy?Peanut allergies occur when the immune system mistakenly identifies proteins in peanuts as harmful, triggering histamine release.
The most common cause of peanut allergy symptoms is eating peanuts or foods that contain peanuts. However, exposure to peanuts can also occur in other ways, including:
Direct skin contact: In some cases touching peanuts can result in allergic reactions, especially if you rub your eyes after touching peanuts or a surface with the allergen on it.
Cross-contact: Peanut proteins can be unintentionally transferred from food containing peanuts to food not containing them during preparation. This cross-contact (also called cross-contamination) can result in a severe allergic reaction.
Inhalation: Peanut dust and particles containing peanut proteins that become airborne may cause an allergic reaction. Some people report chest tightness or skin rashes when being near or smelling peanut butter. However, studies have yet to confirm these effects.
Diagnosing a peanut allergy can be challenging because symptoms vary from person to person. If you suspect you have a peanut allergy, it's important to contact an allergist, who will typically ask about your personal and family histories and may order a skin or blood test.
The allergist may also recommend an oral food challenge, in which you will be fed tiny amounts of peanut or peanut products under medical supervision in progressively increasing amounts.
At-Home Food Allergy TestsMost at-home food allergy test kits measure immunoglobulin E (IgE) antibody levels in your blood to identify a potential food allergy. Experts don't recommend them as they may not provide accurate results and may be challenging to interpret. If you try an at-home allergy test, review your results with a healthcare provider to receive an official peanut allergy diagnosis.
How Can I Prevent Reactions?The best way to prevent allergic reactions is to avoid peanuts and products containing peanuts. Peanuts and peanut products are found in many foods, including baked goods, cereals, candies, and pies.
The Food Allergen Labeling and Consumer Protection Act requires major allergens, including peanuts, to be declared at least once on food ingredient labels.
Foods not made with peanuts can still be at risk of cross-contamination during processing or preparation, which means traces of peanuts may be present in these products. Read labels carefully and avoid products that say "may contain peanuts," "made in a facility that processes nut ingredients," or something similar if you have a peanut allergy. However, these are voluntary statements that are not required by law.
When eating out, ask restaurant staff about the ingredients used to prepare meals. Avoid eating Asian and Mexican cuisine, in which peanuts are frequently used.
It's also important to be mindful when consuming foods that contain tree nuts, like walnuts, almonds, and pecans, as 30% of individuals with peanut allergies are also allergic to tree nuts.
Oral Immunotherapy for Peanut AllergiesThe Food and Drug Administration (FDA) approved Palforzia, a peanut protein powder used to treat peanut allergies in children ages 4 to 17. It slowly introduces a child to peanuts, so their immune system is less likely to react if peanut products are accidentally ingested. Even with this medication, peanuts should be avoided, and epinephrine should always be available.
SummaryPeanut allergy is one of the most common food allergies. Symptoms can range from mild to life-threatening, including runny nose, hives, facial swelling, and anaphylaxis in rare cases. Most peanut allergies start in the first few years of life, but it's also possible for adults to become allergic to peanuts. If you suspect you have a peanut allergy, contact an allergist who can perform testing to confirm whether you are allergic to peanuts.
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Differences In Gut Bacteria Can Be Early Indicators For The Development Of Peanut Allergies
A new study led by researchers at the Icahn School of Medicine at Mount Sinai has revealed key differences in gut bacteria and their metabolic byproducts in infants that may predict the development of peanut allergies by mid-childhood. The findings, published online August 22 in the Journal of Allergy and Clinical Immunology, could pave the way for new strategies to prevent or treat this increasingly common food allergy.
The multi-center longitudinal study monitored infants known to be at risk for allergies but who hadn't yet developed a peanut allergy. By analyzing fecal samples from infancy and later in childhood, the researchers were able to identify specific differences in gut bacteria and the metabolites they produce between children who did and did not develop a peanut allergy by around age 9.
Key findings of the study include:
Senior author, Supinda Bunyavanich, MD, MPH, MPhil, the Mount Sinai Endowed Professor in Allergy and Systems Biology and Deputy Director of the Elliot and Roslyn Jaffe Food Allergy Institute, highlighted the significance of the study: "It's a major step forward to understand that specific patterns of gut bacteria and their metabolic products can be early indicators for the development of peanut allergies. This offers a unique perspective into potential preventive strategies that could have a profound impact on how we address peanut allergies in children."
However, Dr. Bunyavanich also cautioned against drawing premature conclusions: "While it's exciting to think our gut bacteria might influence our risk of developing allergies, it's crucial to note that altering a child's gut bacteria isn't yet an immediate solution. We need further research to truly harness these findings."
The study is one of the first of its kind to longitudinally track changes in gut bacteria and their byproducts from infancy to childhood, specifically in relation to peanut allergy development. The insights gleaned could lead to innovative approaches, such as probiotics or dietary interventions, to manage and prevent peanut allergies in children, improving countless lives.
The researchers acknowledge that while their findings present strong associations between the gut environment and peanut allergy development, it's not yet confirmed that these bacterial changes directly cause the allergy. Future studies with expanded sample sizes and clinical trials will be essential to strengthen these links.
Source:
Journal reference:
Chun, Y., et al. (2023) Longitudinal dynamics of the gut microbiome and metabolome in peanut allergy development. Journal of Allergy and Clinical Immunology. Doi.Org/10.1016/j.Jaci.2023.08.012.
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