Deaths in children, adolescents, and adults who
ingested foods to which they were highly allergic have been reported.1,2
These deaths are often caused by a "hidden" ingredient in the food to
which the individual is allergic.1,3 Yunginger1 suggests
that in the United States, more children and adolescents die annually as a
result of food-induced anaphylaxis than as a result of insect stings. The
majority of these deaths are due to severe allergy to peanut and nuts, and
asthma appears to be an important risk factor for this form of allergy.2
Sensitivity can occur by ingestion of minute
quantities of food allergens4,5 and even by inhalation of food
allergens carried in air or in cooking fumes.6-12 The association
between a reaction and a food may not initially he obvious because many
patients experience a reaction only several hours later.13,14 Unlike
the very acute and often dramatic reaction to peanut, the form of reaction to
egg, milk, wheat, and soy may he through "soft signs" (e.g.,
gastroenteropathies, asthma, and atopic dermatitis).12 Other
diagnostic difficulties occur in individuals experiencing anaphylactoid
reactions and in patients with food-dependent exercise-induced anaphylaxis. 15
