BMJ 1995;311:1434 (25 November)

Letters

Benign allergic reactions should not be treated with adrenaline

EDITOR,--The case report of an anaphylactic reaction, presumably to nuts, and Malcolm Fisher's review of anaphylaxis and its treatment are timely.1 The management of children's anaphylactic reactions to foods has recently been reviewed,2 3 and our experience in childhood allergy--in particular, peanut allergy--prompts us to emphasise some additional points and to urge clarification of terminology.

Fatal and near fatal anaphylaxis related to foods most commonly occurs in patients who have had previous severe reactions, which makes the history crucial rather than "of little value," as Fisher seems to suggest.1 A high risk of anaphylaxis related to food is associated with poorly controlled asthma and the requirement of oral corticosteroids and with delay in the administration of adrenaline.4

Doctors who may encounter an anaphylactic emergency must be aware that ß blocking drugs may potentiate anaphylaxis5 and that fatal and near fatal reactions to foods sometimes proceed in the absence of signs of . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Treatment of acute anaphylaxis
Malcolm Fisher
BMJ 1995 311: 731-733. [Abstract] [Full Text]

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