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Food Hypersensitivity 187

degree of avoidance needed is very individual. It is mainly severe response or a slower, less severe
important to monitor the condition so that foods response depending on whether the antibody
are not excluded for longer than is necessary. immunoglobulin E (IgE) is released by the immune
system or not. Not all allergic reactions involve the
Food hypersensitivity production of IgE.

Food allergy Non-allergic food IgE-mediated food allergy
hypersensitivity In infants and children who do make the specific
(commonly called antibody IgE to a food, a protein in the food reacts
food intolerance) with the IgE and one or more of the following
symptoms will appear within two hours of eating
IgE-mediated food Non-IgE-mediated the food:

allergy food allergy ●● diarrhoea

- symptoms appear - symptoms appear ●● asthma/wheeze

very quickly slowly ●● breathing difficulties

Figure 7.1.1 Classification of adverse reactions to ●● eczema gets worse
food
●● hives (blotchy red rash) or urticaria
Food allergy
●● itching
The foods that are most likely to cause an allergic
reaction vary from country to country. In the UK ●● pallor
they are:
●● rashes
●● cow’s milk – more likely in infancy
●● redness – particularly a red facial flush in
●● eggs infants and young children

●● peanuts, also called ground nuts ●● swelling of lips, tongue, face

●● tree nuts – almonds, hazelnuts, walnuts, cashew ●● vomiting
nuts, pecan nuts, brazil nuts, pistachio nuts,
macadamia nuts and Queensland nuts ●● anaphylaxis.

●● fish Anaphylaxis is the most serious reaction and
includes breathing problems, and a rapid drop in
●● shellfish – prawn, shrimp, crab, lobster and blood pressure. Children who suffer in this way
crayfish need immediate medical attention. Death from
fatal allergic reaction to food is rare: around 1 in
●● wheat 800 000 per year. Children with asthma have the
highest risk.
●● soya
Parents of children at risk of anaphylaxis need to
●● sesame be taught how to use an adrenaline auto-injector
(e.g. Epipen or Anapen). The adrenaline reverses
●● kiwi fruit. the reaction. Two adrenaline auto-injectors need to
be with the child at all times so that it can be
When an infant or child is allergic to a food, a accessed rapidly and used in an emergency.
protein in that food triggers their immune system
to respond in a variety of ways. It may be a rapid, The Anaphylaxis Campaign provides useful
information for food allergy sufferers with
anaphylaxis (www.anaphylaxis.org.uk).