Frequency of individual symptoms

Table 4.2 shows the frequencies of each allergic symptom in the first and most recent reactions to peanut in the author's Southampton study.21 Most symptoms occurred in varying combinations. The most common features were facial swelling and rash and these nearly always occurred together.

Vomiting and abdominal pain (not shown in the table) were rarely isolated features of a reaction. Abdominal pain correlated more strongly with severe symptoms than did vomiting. Abdominal pain also correlated more strongly with severe symptoms than did more minor symptoms such as rash or itch. Abdominal pain may be an under-appreciated symptom of at least moderately severe allergic reactions to peanut.

The most severe symptom, collapse, never occurred in isolation and was always associated with some other preceding symptom. In subjects whose most recent reaction was characterised by collapse (46 subjects) facial swelling was present in 83%, wheeze in 74% of cases, itch in 67%, rash in 59% and vomiting in 50% of cases.10,22

Table 4.2 Features of first and most recent reactions to reaction to peanut

Symptom First reaction Most recent reaction

Facial swelling

Rash

Itch

Vomiting Wheeze

Breathing difficulty

Cyanosis

Collapse

444 (72) 399 (64) 342 (55) 240 (39) 239 (38) 229 (37) 88 (14) 42 (7)

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