reaction question...

Posted on: Wed, 01/09/2008 - 4:26am
KaraLH's picture
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Joined: 10/11/2006 - 09:00

This may be a strange question but, is it possible to have an anaphylactic reaction by contact only, or does the food or other need to be ingested? My daughters last reaction with egg was "epi in the hand" bad, but after double dose of benadryl the swelling and "something in my throat" feeling got better. That was after what we know to be a contact to egg. Not ingested.

Anyway, it got me thinking and I wondered if anyone had that answer? (this reaction was her last, luckily several months ago already.)

I also am going to our school with another allergy mom on Monday to do a small presentation to the preschool staff on food allergies. In all of my research, I can't find an answer to that. I thought I should have facts straight.

Thanks
Kara

Posted on: Wed, 01/09/2008 - 4:50am
niche's picture
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Joined: 02/05/2007 - 09:00

Hi,
Q - how old is your daughter? In my reading many Dr's state that contact reactions would only cause localized reactions that shouldn't move on to be systemic. However, I have read many stories of folks who relate reactions that have moved past localized reactions to either contact or aresol exposures.
When I did a presentation at my kids school I noted that for their age range (2-6) some Dr's do state that due to the tendancy of children in this age bracket to put their hands or items in thier mouth or to touch their eyes contact could cause a reaction that would require medical attention. Or something to that effect. It is mentioned in detail in Dr Sicherer book Understanding and managing your childs food allergies. some on pgs 196-197 and more on 211-213
Hope that helps,

Posted on: Wed, 01/09/2008 - 12:49pm
KaraLH's picture
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Thank you for your reply. My dd is 3 1/2 and what you said makes perfect sense. Thank you for the other resource too. This will be a very low key presentation, but hopefully a good start.
Kara

Posted on: Thu, 01/10/2008 - 10:23am
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

Right--if you touch an allergen it isn't likely to cause a reaction by itself but if you then touch your eyes, nose or mouth (which children *and* adults do all the time!) you have thereby ingested the allergen so ana can occur. For this reason, contact should be totally avoided.
Do you have an action plan? Did you talk with your allergist about this?
Best wishes!

Posted on: Fri, 01/11/2008 - 8:51pm
Colleencz's picture
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Joined: 01/10/2008 - 16:39

I am pretty new to all of this, my daughter was only diagnosed on Thursday but my doctor said if she has contact with peanuts or pb it should only cause a localized reaction. I am still supposed to avoid her contact as much as possible.
It would make sense though if she touched the egg and then put her hand in her mouth she could have a bad reaction. I know my daughter is always putting her hands in her mouth so I could see a problem if she touched PB then put her hand in her mouth before I noticed.

Posted on: Sat, 01/12/2008 - 8:15am
mpeters's picture
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My daughter has definitely had systemic responses to contact (even indirect via a previously contaminated surface). Her response includes rash over the body (not just where the contact occured) flushing, eyes watering and swelling, general itching and sometimes wheezing (she has asthma). She is 10 so she is not mouthing her hands. The good news is that these reactions have been controlled with Benadryl, antihistamine eyedrops, and albuterol inhaler.
We almost (and probably should have) used the epi once for a horrible reaction to direct contact (she was scooping birdseed with her hands and peanuts were in the seed mix but she was only 2 and newly diagnosed and we didn't realize what was happening. Her face blistered from the swelling and she looked like she had two black eyes the next day. I think we included inhaled steroids in the treatment that time.

Posted on: Mon, 01/14/2008 - 11:11am
KaraLH's picture
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Joined: 10/11/2006 - 09:00

Thanks for the replies!
I and another mom did a presentation today for the preschool staff at school. Really just allergy basics. It went very well though. A lot of talk about how different reactions can be from one child to the next.
It was well presented and well excepted in my opinion. (of course the other mom did the majority of the talking!!!)
anyway, thank for your help.
Kara

Posted on: Mon, 01/14/2008 - 11:19am
lakeswimr's picture
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Originally Posted By: mpetersMy daughter has definitely had systemic responses to contact (even indirect via a previously contaminated surface). Her response includes rash over the body (not just where the contact occured) flushing, eyes watering and swelling, general itching and sometimes wheezing (she has asthma). She is 10 so she is not mouthing her hands. The good news is that these reactions have been controlled with Benadryl, antihistamine eyedrops, and albuterol inhaler.
We almost (and probably should have) used the epi once for a horrible reaction to direct contact (she was scooping birdseed with her hands and peanuts were in the seed mix but she was only 2 and newly diagnosed and we didn't realize what was happening. Her face blistered from the swelling and she looked like she had two black eyes the next day. I think we included inhaled steroidsin the treatment that time.
We are to give the epi for any sytemic reactions and certainly for anything involving breathing. Not to butt in where Im not asked but I wonder if you have a board certified allergies and an emergency plan. I question any plan that doesn't call for giving the epi for sytemic reactions. There is a range in what allergists recommend but all allergists I know of recommend an auto epi for breathing difficulties in response to contact or ingestion of an allergen. Inhalers are not proper treatment for anaphylaxis. For hives or swelling or itching over the body I would give the epi. This is systemic. if there are hives/swelling/itching outside it could be happening inside, too.
If you don't have a board certified allergist I hope you will get one.
I hope you don't mind my unasked for advice. Very best wishes.

Posted on: Mon, 01/14/2008 - 11:36pm
mpeters's picture
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Joined: 10/28/2001 - 09:00

To Kara,
Congrats on your presentation, it always feels good when you are well received, and I am sure it is a relief to have it done!
To Lakswimr,
Your advice is well received, and you are absolutely right. When our daughter was 2 we had not seen the allergist yet and we were still truly in denial (beleive it or not we did not even identify peanuts as the culprit until the next day) If the same thing happened now I am certain our response would be different, which is why I say we [u]should[/u] have used the epi (and would if the same event occurred again). We do have a plan in place and all the meds and are under the care of a certified allergist.
She is 10 now and does not scoop her hand into peanuts, thank goodness! So her contact responses (although systemic) are to trace contamination on surfaces so are not nearly as bad. I feel comfortable with treating her with alternatives rather than the epi, which also requires an ER visit. (keep in mind that these reactions for her occur probably 4-8 times per month) I work at her school (and dance and gymnastics too) so I am able to keep close watch on her whenever it happens. But generally I expect others to follow the plan and advise them, if unsure give the epi. Thanks for speaking up.

Posted on: Wed, 01/16/2008 - 5:15am
lakeswimr's picture
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Joined: 02/01/2007 - 09:00

Glad you didn't get offended. :) I would have felt badly if I didn't say anything and you didn't know the things I posted and your daughter had a bad reaction, you know?
4-8 times month! Wow! I wonder if you can get some of those people to do a better job washing their hands! It is good she is old enough to know not to touch her face.
Best wishes!

Posted on: Wed, 01/16/2008 - 11:52pm
mpeters's picture
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We are making progress, but it is an ongoing challenge to manage contact issues. She is in 4th grade so 1st through 3rd have already eaten and touched everything on the playground before she gets there. We now have a hand wipe station at the exit of the cafeteria with a sign asking those who had peanut-butter to wipe their hands. It is helping. She is also staying in as an office aid 2 days per week instead of recess (don't worry, she loves it and they spoil her with prizes and safe treats in the office). At gymnastics, they have tried to keep peanuts out and inform everyone, but there is a lot of kid traffic through there, so it is hard. They also try for peanut free at dance, but she has had problems (because they hold hands in some of their dances) when kids have snacked prior, even if they washed hands. (I have even wondered if they can sweat out peanut protein, does anyone know?)

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