title: [Anaphylaxis in two children caused by peanut and nut allergies; recommendations for treatment].
abstract: Two girls aged 12 and 7 years with asthma and peanut and nut allergy developed anaphylactic shock after ingestion of peanuts and nuts from an unreported source. They were both given intramuscular epinephrine. The 12-year-old girl was treated clinically for shock and after two days was discharged from hospital. The 7-year-old girl died. Risk factors for life-threatening anaphylactic reactions are adolescent to young adult age, asthma, previous severe anaphylactic reactions to the food in question, previous reaction to small dose of the food in question and allergy to peanuts or tree nuts. A double-blind, placebo-controlled food challenge should be carried out to document the culprit food. The most important therapeutic intervention is the intramuscular administration of epinephrine. For patients with two or more risk factors the prescription of an epinephrine auto-injector should be considered.
authors.affiliation: Universitair Medisch Centrum Groningen, Beatrix Kinderkliniek, Postbus 30.001, 9700 RB Groningen. m.m.boeve@bkk.umcg.nl
authors.forename: M M
authors.initials: MM
authors.lastname: Boeve
authors.forename: B L
authors.initials: BL
authors.lastname: Rottier
authors.forename: J
authors.initials: J
authors.lastname: Mandema
authors.forename: E H H M
authors.initials: EH
authors.lastname: Ríngs
authors.forename: J K W
authors.initials: JK
authors.lastname: Kieboom
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000188:drug therapy*; D002648:Child; D004837:Epinephrine / Q000627:therapeutic use*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D021184:Nut Hypersensitivity / Q000188:drug therapy*; D021183:Peanut Hypersensitivity / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000318:Adrenergic beta-Agonists; D004837:Epinephrine