Purpose of StudyThe purpose of this paper was to report clinical and laboratory findings from seven cases of fatal anaphylaxis due to foods.Study PopulationThe report was based on the findings from seven patients ranging from 11 to 43 years of age: two female and five male patients. The cases were evaluated over a 16-month period.MethodsSerum samples were obtained from six of the seven cases during resuscitation attempts or at autopsy. Food-specific IgE antibodies were measured by solid-phase radioimmunoassay.FindingsElevated levels of IgE antibodies to the incriminated foods were present in the six cases where the serum was available for study. Three were due to peanut and one each were due to pecan, crab, and cod. The seventh case (without serum) was due to peanut. The patients had some features in common: Most were highly atopic; most reactions occurred away from home; all had previously had generalized immediate reactions to the food; and none were on β-adrenergic blocking agents.Several recommendations are made by the authors. Patients and physicians must be made aware of the potential consequences of severe systemic reactions to foods. Patients and physicians must know that the immediate treatment is injectable, aqueous adrenalin not oral antihistamines, nor epinephrine by metered-dose aerosol or in suspension. The patients should have the adrenalin available to them at all times and know how to administer it. Patients receiving concomitant steroid therapy should be assumed to have adrenal suppression and treated appropriately during resuscitation. Ingredients of prepared foods must be made available and patients (and/or their families) must use this information to try to avoid catastrophic results.
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