[chris (OP)]

People With Food Allergies Should Not Only Be Careful About What They Eat, But Whom They Kiss, Says Mayo Clinic Report

David Steensma, M.D., Mayo Clinic hematologist, writes about the case of a 20-year-old woman who is allergic to shellfish and experienced a severe allergic anaphylactic reaction immediately after she kissed her boyfriend. The boyfriend had eaten several shrimp less than an hour earlier.

"It is important to warn susceptible patients that food does not actually have to be eaten to trigger an allergic reaction," says Dr. Steensma. "Touching the offending food and kissing or touching someone who has recently eaten the food can be enough to cause a major reaction," he says.

Kissing has been recognized only recently as a vector for transmitting food allergens, Dr. Steensma writes in the Proceedings article.

In the case of the woman, she experienced a reaction in her lips and skin, had throat swelling, diffuse flushing, abdominal cramps, nausea and wheezing with symptoms beginning less than one minute after she kissed her boyfriend. She was treated at the emergency department of a Mayo Clinic-affiliated hospital, where she was given a prescription for an adrenaline injection kit, counselled to scrupulously avoid shellfish exposure, and instructed to follow up with her primary-care physician.

The couple worked at a seafood restaurant, and the woman sometimes wore gloves while serving food. However, the night of her severe reaction, she reported no distress or symptoms prior to the kiss. The patient had repeatedly touched shellfish while on the job and, as a consequence, had experienced a series of mild allergic reactions. These minor reactions may have served to "prime " her immune system to produce more antibodies directed at crustacean proteins, a phenomenon that is similar to reactions people have to seasonal allergens such as ragweed and other noxious pollens.

"This case report underscores the importance of carefully counselling all patients who are allergic to food that they must avoid exposure to offending proteins via all potential routes of contact, including kissing and touching," Dr. Steensma says. "Carrying an injectable adrenaline kit and having been instructed in its use, and wearing emergency medical information, such as a Medic-Alert bracelet, may also be helpful for patients susceptible to severe allergic reactions."

[bezoar]

It always amazes me that food allergies can be so serious.  When I worked in the Emergency Room, I remember a patient that came in with and allegic reaction to strawberries.  It wasn't her first exposure.  She arrested and we almost didn't get her back -- all because of strawberries in her dessert.  Unbelievable.

Bezoar

[baby2michaelt]

it is unbelievable, but the fact that some people grow out of their allergic reaction  to foods is amazing, can anyone explain that?

baby2michaelt[}:)]

[tweener]

When my son was a baby, he was terribly allergic to milk and glutenous grains (almost all but rice).  He was nursing at the time, and if his mom ate any amount of milk or whey or wheat (even as a minor additive in some other food) he would react.  She lost a lot of weight, but managed to keep him healthy.  It was amazing how sensitive he was, even filtered through her body.  Finally, he grew out of his allergies.  He is still a little bit lactose intolerant, but that's all.

----
John - The Eternal Pessimist.

[chris (OP)]

Lactose intolerance is cause by a deficiency of the digestive enzyme "lactase" which breaks down "lactose" the predominant form of sugar found in milk (lactose is a dissacharide formed by the linkage of a glucose molecule with a galacose molecule - lactase breaks them apart). Undigested lactose then enters the large bowel where it causes osmotic diarrhoea and it is also metabolised by colonic bacteria producing bloating, cramps and wind.

Some people are born with an absolute lactase deficiency and are affected from birth. In others the condition may worsen slightly with age, but most people can tolerate a small amount of lactose in a day.

Interestingly, whilst most people in Europe and North America can digest lactose, the bulk of the world's population (over 75%) are effectively lactose intolerant !

Chris

"I never forget a face, but in your case I'll make an exception"
 - Groucho Marx

[rpack]

My next door neighbor has us watch her child (4yo) for the weekend , little did we know of the SEVERE PEANUT ALLERGY! Nor were we warned. If the parents would have gotten him a medical id bracelet for over nights or when they are not around it would have been a better weekend for us ALL!

RP
newbielink:http://www.medicalidalertbracelet.com [nonactive]
Virginia

[gsmollin]

The woman with the deadly seafood allergy works in a seafood restaurant??? Maybe she should change jobs!

[gsmollin]

The woman with the deadly seafood allergy works in a seafood restaurant??? Maybe she should change jobs!

[curious]

I have not been able to find out how to prevent causing an allergic reaction if I have eaten shellfish (my girlfriend is allergic to shellfish).  I have been avoiding shellfish, but if I eat some, how long should I wait before kissing?  Is brushing and washing my lips sufficient?  

Thanks for any suggestions.

[sprite190582]

I have a nut allergy and my boyfriend has caused me to have a reaction by accidently eating something with nuts in then kissing my over an hour later. How mad is that!

Alex

[neilep]

Alex..that is well bonkers !!..I would not wait an hour before kissing !![][]....but seriously....I presume you must be very sensitive to nuts !!....it just goes to show how careful one should be....when you go out for a meal do you have to keep on asking about the ingrediants etc ? and shopping must be a chore too eh ?.....all this and back ache too eh ? *sigh...what a bummer*

'Men are the same as women...just inside out !'

[Ylide]

Yep, I've seen someone react to a shellfish allergy from a kiss, too.  My friend Dave and I went to the Mongolian Barbeque and he had a dish with scallops in it.  Several hours later, he gave his girlfriend a kiss when we got back to his house and she ended up in the emergency room.  Scary.  I can't imagine being that allergic to something.



This message brought to you by The Council of People Who Are Sick of Seeing More People

[Nytmare_Muise]

i am severely allergic to peanuts, my if the proteins in them touch any part of a mucous membrane in my body it causes severe hives to form.  If i eat any of it, it causes my throat to close over. If my girlfriend eats any kind of peanuts now i wait hours to go by and alot of liquids and teeth brushing before i kiss her

"Do or do not, there is no try" ~Yoda

[chris (OP)]

The severe reaction that people develop in response to allergens like peanuts or shellfish, drugs or insect bites and stings is called anaphylaxis. It is essentially immune allergic meltdown and the name was coined by scientists who were trying to protect dogs against a toxin by injecting them with tiny doses. But far from protecting them (prophylaxis) the dogs died - and the term anaphylaxis was born.

Anaphylactic reactions, which can be life threatening, are caused by massive release of histamine and other inflammatory agents whenever the individual comes into contact with the allergen responsible. This causes airway swelling and constriction (which can obstruct breathing) and vasodilatation (opening up of blood vessels) which can lead to a precipitious drop in blood pressure.

The histamine is released by Mast cells, large spiky cells which sit in our mucous membranes and in the skin. These granulated cells are coated with IgE antibodies and resemble a second world war marine mine. Their role is to function as an early-warning system in our tissues. Whenever something nasty appears, the IgE locks onto it and triggers the mast cell to 'degranulate' which means it discharges its stores of histamine, and other inflammatory mediators, which together alert, and attract, the other components of the immune system to the troublespot.

But why this process should go so out of control in some people is not known. Indeed why do we 'tolerate' (i.e. not react) to most foods but then over-react to a single component of others (like peanuts) ?

What we do know is that the IgE antibodies responsible for producing the reaction can recognise even tiny traces of the offending proteins, which is why only a minute amount needs to be present in order to produce the symptoms.

The remedy is adrenaline injection which helps to maintain blood pressure and cerebral perfusion, and also causes bronchodilatation (airway relaxation). As soon as possible patients are also given a big dose of steroids to help damp down the inflammatory process. Anti-histamines are of little use because, once the histamine has been released from the Mast cells, administering an anti-histamine is like slamming the door after the horse has bolted.

It's a very worrying condition for people who have allergies because they are always concerned that traces of the proteins they are allergic to may have crept into the things they eat. For this reason most sufferers wear a medic-alert bracelet (so first aiders, paramedics and doctors know immediately what is wrong if they should collapse), and also carry an adrenaline-pen (an adrenaline-injector) with them.

Chris



"I never forget a face, but in your case I'll make an exception"
 - Groucho Marx

[sprite190582]

Chris (or any one who may know the answer), Why do some people require a larger does of adrenaline than others? I am allergic to nuts and started off with an epi-pen junior as a child then progressed to an epi-pen. After my last reaction I was told to carry and inject 2 epi-pens as one was having little effect. They then prescribed me a pre-filled syringe containing a whole 1mg of 1:1000 adrenaline and told me to inject the whole lot of I have a reaction, surly this is too much? My allergy doctor at the local hospital assures me it will do me no hard but I am still a bit worried.

Alex

[Nutrovitasub]

The term allergy is used to describe a response, within the body, to a substance, which is not necessarily harmful in itself, but results in an immune response and a reaction that causes symptoms and disease in a predisposed person, which in turn can cause inconvenience, or a great deal of misery. An allergic reaction is a physiologic response by our body against: something we have swallowed; something we have inhaled; something which has touched our skin; or, something injected into us by a bite, a sting from an insect, or by a syringe needle. Nuutrovita.com Offers a wide variety of top brands Allergy releif products.

Allergy Store
http://www.nutrovita.com/store/Allergy-Treatment.htm [nofollow]

Allergy Blog
http://allergytreatment.spaces.live.com/ [nofollow]

Allergy Treatment Article
http://www.nutrovita.com/info/Allergy_Treatment.htm [nofollow]

http://www.nutrovita.com [nofollow]

[Bored chemist]

By an odd coincidence last night I watched CSI and it mentioned that it's not just kissing that can cause problems.
There's a synopsis of the plot here (and please be aware that show is broadcast after the "watershed"- some of the themes are "adult only".)
http://en.wikipedia.org/wiki/Ending_Happy_(CSI_episode)
I don't know if its based in reallity but it seems plausible to me. (Not the whole story Good lord no, that's never plausible in a million years- just the bit about transfer of the alergen)

[paul.fr]

By an odd coincidence last night I watched CSI and it mentioned that it's not just kissing that can cause problems.
There's a synopsis of the plot here (and please be aware that show is broadcast after the "watershed"- some of the themes are "adult only".)
http://en.wikipedia.org/wiki/Ending_Happy_(CSI_episode)
I don't know if its based in reallity but it seems plausible to me. (Not the whole story Good lord no, that's never plausible in a million years- just the bit about transfer of the alergen)

i watched the same episede a few months back, i wonder if it is possible?

[crespowu]

avoid exposure to offending proteins via all potential routes of contact, including kissing and touching

That's a bad news for young guys.

[4312]

congestion of the liver and its inability to remove toxins increases due to the American and European type of diet