SEVERE FOOD ALLERGIES

Severe food allergies can either be life-threatening shortly after exposure to the offending food (IgE-mediated) or cause nutritional, growth or circulatory compromise after repeated ingestion of the allergen (non-IgE-mediated). Such allergies can have a major impact on the quality of life of patients and their families. Severe food allergies appear to be increasing worldwide and peak in preschool years, though fatal food allergies peak in adolescence and early adulthood. Fatal food allergic reactions are most commonly described with nuts and seafood, and in many cases the patient had been diagnosed with a food allergy but had not previously had a severe reaction to the food. Asthmatics and adolescents are at particular risk of fatal or near-fatal food allergic reactions and should be offered specialist care. Effective management of the patient with severe food allergy requires a multidisciplinary approach involving allergists, emergency care physicians, dieticians, caregivers and school personnel. A comprehensive emergency plan is central. Early recognition and treatment of food allergy reactions can be life-saving.