Published Research Highlights of 2000

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Fatal and near-fatal anaphylactic reactions to food in children and adolescents 
Sampson HA, Mendelson L, Rosen JP 
Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, MD. 
New England Journal of Medicine 1992;327(6):380-4 
The authors investigated six children and adolescents who died from anaphylaxis to food, and seven others who nearly died and required intubation. The investigation included a review of emergency medical care reports, medical records, depositions by witnesses to the events, and interviews with parents and patients. The authors conclude that the failure to recognize the severity of the reactions and to administer epinephrine promptly increases the risk of a fatal outcome. 
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Outdated EpiPen and EpiPen Jr. autoinjectors: past their prime? 
Simons FE, Gu X, Simons KJ 
Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Canada. 
J Allergy Clin Immunol 2000;105(5):1025-30 
The purpose of this study was to evaluate unused, outdated EpiPen and EpiPen Jr auto-injectors that were obtained from patients who were prescribed the medication. Investigators found that auto-injectors that had been expired 1 to 90 months had a reduced potency compared to epinephrine that had not expired. Investigators concluded that non-expired EpiPen and EpiPen Jr be used for prehospital treatment of anaphylaxis, and that if the only auto-injector available is expired, it could be used if there is no discoloration of the medicine, or if precipitates aren't apparent because the potential benefit of the drug is greater than the potential risk. 
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Public perception of food allergy 
Altman DR, Chiaramonte LT 
Food Allergy Center, Lynbrook, NY, USA. 
J Allergy Clin Immunol 1996;97(6):1247-51 
The objective of this study was to determine the American public's belief in food allergy. Five thousand households were surveyed in 1989 (79% response rate), 1992 (75% response rate), and 1993 (74% response rate). Of responding households, 16.2%, 16.6%, and 13.9%, respectively, reported an average of 1.17 members of their household who had a food allergy. 
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The natural history of peanut allergy in young children and its association with serum peanut-specific IgE 
Vander Leek TK, Liu AH, Stefanski K, Blacker B, Bock SA 
Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 
Journal of Pediatrics 2000;137(6):749-55 
The authors identified 83 children diagnosed with peanut allergy prior to their fourth birthdays, and contacted the children annually for a five-year period to determine the nature and frequency of allergic reactions caused by accidental exposure to peanut. The authors found that the majority of children had adverse reactions from accidental exposure during the five-year follow-up, and that the symptoms experienced during these subsequent reactions were not necessarily consistent with symptoms reported during initial reactions. The authors also concluded that young children can outgrow their allergy to peanut. 
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Use assessment of self-administered epinephrine among food-allergic children and pediatricians 
Sicherer SH, Forman JA, Noone SA 
Division of Allergy and Immunology, Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY 
Pediatrics 2000;105(2):359-62 
The authors sought to determine the ability of families with food-allergic children and pediatricians to properly use self-injectable epinephrine. One hundred one families participated in the study. The authors found that many parents of severely food-allergic children, and food-allergic teenagers cannot correctly administer their self-injectable epinephrine, and may not have the medication readily available in the event of a reaction. The authors also found that pediatricians are not familiar with these medical devices, and may fail to review their use with patients. 
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