Wüthrich B
Department of Dermatology, University Hospital, Zürich, Switzerland.
J Investig Allergol Clin Immunol. 2000 Mar-Apr;10(2):59-65.
Fatal or life-threatening anaphylactic reactions to food occur in infants, children and adults. Atopic individuals with bronchial asthma and prior allergic reactions to the same food are at a particularly high risk, whereby even the mere inhalation of the allergenic food can be fatal. Not only peanuts, seafood and milk can induce severe, potentially lethal anaphylaxis, but indeed a wide spectrum of foods, according to the different patterns of food sensitivity in different countries. Foods with "hidden" allergens and meals at restaurants are particularly dangerous for patients with food allergies. Similarly, schools, public places and restaurants are the major places of risk. However, the main factor contributing to a fatal outcome is the fact that the victims did not carry their emergency kit with adrenaline (epinephrine) with them. In cases of death where food anaphylaxis is suspected, it is important for forensic reasons to preserve uneaten portions of the food in order to identify (hidden) allergens. It is also important to determine postmortem specific serum IgE, tryptase and histamine levels to document the anaphylaxis. There is a need to raise awareness of the diagnosis and treatment of anaphylaxis among doctors, those called upon to administer emergency medical care, and the public, and also to provide increased support for those with potentially fatal food allergies through the help of patients' organizations, and national and international medical societies. The food industry should ensure a policy of comprehensive labelling of ingredients so that even the smallest amount of potentially lethal foodstuffs can be clearly identified. Finally, the pharmaceutical industry should be persuaded to reintroduce an adrenaline inhaler onto the market.
婴儿、儿童和成人都会发生对食物的致命或危及生命的过敏反应。患有支气管哮喘且之前对同一种食物有过敏反应的特应性个体风险尤其高，在这种情况下，即使仅仅吸入致敏食物也可能致命。根据不同国家食物敏感性的不同模式，不仅花生、海鲜和牛奶会引发严重的、可能致命的过敏反应，实际上多种食物都可能如此。含有“隐藏”过敏原的食物以及餐厅的饭菜对食物过敏患者尤其危险。同样，学校、公共场所和餐厅是主要的风险场所。然而，导致致命后果的主要因素是受害者没有随身携带含肾上腺素的急救包。在怀疑因食物过敏反应导致死亡的案例中，出于法医鉴定的原因，保留未食用的食物部分以识别（隐藏的）过敏原很重要。确定死后特定的血清IgE、类胰蛋白酶和组胺水平以证明过敏反应也很重要。有必要提高医生、负责提供紧急医疗护理的人员以及公众对过敏反应诊断和治疗的认识，并通过患者组织以及国家和国际医学协会的帮助，为有潜在致命食物过敏的人提供更多支持。食品行业应确保实施全面的成分标签政策，以便即使是最少量的潜在致命食品也能被清晰识别。最后，应说服制药行业重新将肾上腺素吸入器推向市场。
