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Peanut Anaphylaxis From Food Cross-Contamination

Stephen F. Kemp, MD; Richard F. Lockey, MD
JAMA. 1996;275(21):1636-1637. doi:10.1001/jama.1996.03530450026022.
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To the Editor.  —A minimum of 950 food-induced anaphylactic reactions probably occur each year in the United States.1 Peanuts appear to cause most episodes.2 This letter reports anaphylaxis occurring in a physician allergic to peanuts following the ingestion of peanut contaminated cookies.

Report of a Case.  —I (S.F.K.) am a 34-year-old allergist-immunologist with a medical history that includes allergic asthma and anaphylaxis induced by peanuts, almonds, and pecans. I ate approximately 20 gingersnap cookies (Murray Cookies, President Baking Company, Augusta, Ga). The package label did not list peanuts among the ingredients. Palatal itching commenced within 5 minutes of ingestion and was followed progressively by dysphagia, abdominal cramps, tachycardia, bronchospasm, generalized erythema, peripheral cyanosis, lightheadedness, rhinitis, and conjunctivitis. Epinephrine and loratadine were self-administered with prompt relief of symptoms. At the emergency department 30 minutes later, recurrent bronchospasm, intense pruritus of the palms, and generalized urticaria occurred and necessitated administration


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