CONTROVERSY

Allergy

Food allergy in childhood

A T Clark, P W Ewan

Addenbrooke’s Hospital, Cambridge, UK

Correspondence to:
Correspondence to:
Dr A T Clark, Box 40, Addenbrooke’s NHS Trust, Cambridge CB2 2QQ, UK;
pwe123@hotmail.com

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Have the dangers been underestimated?

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Keywords: allergy; anaphylaxis; food; incidence

The first 150 words of the full text of this article appear below.

Macdougall et al have tried to assess the risks of food allergy in childhood by identifying the incidence of fatal and severe reactions.¹ They conclude that the risk of death is small and play down the importance of severe food reactions. The implication is that epinephrine (adrenaline) autoinjectors are overprescribed. This paper has serious consequences for the management of children with food allergy, so the methodological problems need to be explored to provide a balanced view. The data produced are likely to be misleading by underestimating both severe and fatal reactions.

This is at a time when there is evidence in the UK of a doubling of admissions for anaphylaxis (1991–95),² 385 of whom were children (60 caused by food, but in 240 aetiology was not recorded).³ Food is the commonest cause of anaphylaxis in children,^3–5 and in an American series nuts were the commonest cause of fatal food . . . [Full text of this article]

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This article has been cited by other articles:

• DunnGalvin, A., Chang, W. C., Laubach, S., Steele, P. H., Dubois, A. E. J., Burks, A. W., Hourihane, J. OB. (2009). Profiling Families Enrolled in Food Allergy Immunotherapy Studies. Pediatrics 124: e503-e509 [Abstract] [Full Text]  
• Melville, N, Beattie, T (2008). Paediatric allergic reactions in the emergency department: a review. Emerg. Med. J. 25: 655-658 [Abstract] [Full Text]  
• Hourihane, J. O. (2006). Are the dangers of childhood food allergy exaggerated?. BMJ 333: 496-498 [Full Text]  
• Baral, V R, O'B Hourihane, J (2005). Food allergy in children. Postgrad. Med. J. 81: 693-701 [Abstract] [Full Text]  
• Hu, W., Kemp, A., Kerridge, I. (2004). Making clinical decisions when the stakes are high and the evidence unclear. BMJ 329: 852-854 [Full Text]  
• Clark, A T, Ewan, P W (2004). Food allergy in childhood. Arch. Dis. Child. 89: 197-197 [Full Text]  
• Colver, A F, Macdougall, C, Cant, A (2003). Food allergy in childhood. Arch. Dis. Child. 88: 742-743 [Full Text]  
• (2003). Injectable adrenaline for children. DTB 41: 21-24 [Abstract] [Full Text]  

eLetters:

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ADC Online, 20 Mar 2003 [Full text]

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