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Food‐induced fatal anaphylaxis in adults: respiratory death
Author(s) -
Yunginger J. W.
Publication year - 1992
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/j.1399-3038.1992.tb00052.x
Subject(s) - medicine , anaphylaxis , immunoglobulin e , food allergy , tryptase , epinephrine , incidence (geometry) , immunology , allergy , antibody , dermatology , mast cell , physics , optics
Fatal food‐induced anaphylaxis is rarely reported, and its incidence is unknown. We have identified six adults who experienced fatal postprandial anaphylaxis. Four were highly atopic, and all had experienced prior non‐fatal reactions to peanut, pecan, codfish, or shellfish. In five of six cases, the fatal reaction occurred after dining away from home. All victims had elevated serum IgE antibodies to the incriminated food, and in four cases the mast cell tryptase levels were also elevated. IgE‐antibody containing sera from victims could be used in inhibition immunoassays to test for hidden food allergens in uneaten portions of foods consumed just prior to death. Most fatal anaphylactic reactions to foods are preventable. Sensitized persons may be lulled into false security by the reversibility of previous reactions; may not appreciate possible inadvertent contamination of non‐allergenic foods by allergenic foods; may not appreciate the gravity of symptoms if intoxicated; and may attempt to deny symptoms or treat themselves inappropriately with antihistamines rather than with epinephrine. Patient education efforts should be directed to these areas.