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Treatment for deadly peanut allergy exposes kids to peanuts

By Cynthia H. Craft

The Sacramento Bee (MCT)

Published: Tuesday, July 1 2014 7:54 a.m. MDT

Peanut allergies are exploding in number in babies and children. In response, Mercy Medical Group developed the program to introduce nuts to young patients in very small doses, gradually increasing the child’s exposure to try to lessen the body’s immune system reaction to peanuts.

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Nine-year-old Michael Lee, a bright boy who’s bound for fifth grade in the fall, lives with a serious, life-threatening medical condition. He suffers from a peanut allergy, a growing menace that can make breathing a matter of wishful thinking and anaphylactic shock a horrifying possibility.

So why was Michael sitting at his family’s kitchen table on a sunny and breezy morning last week, calmly and compliantly munching peanuts, one by one, with his mother standing by?

He was eating peanuts in hopes they would control his allergy to peanuts.

Counterintuitive? Yes. Medically risky? You bet. Brave? Definitely.

Michael is the first child in Sacramento selected for enrollment in a novel, new treatment for nut-allergic kids. Developed by allergists at Mercy Medical Group, it’s the first such program to be rolled out in the region. It’s called food oral immunotherapy or, more to the point, peanut desensitization.

Peanut allergies are exploding in number in babies and children. In response, Mercy developed the program to introduce nuts to young patients in very small doses, gradually increasing the child’s exposure to try to lessen the body’s immune system reaction to peanuts.

Since Michael was 4, he has been rushed to the emergency room a number of times, said his mother, Geena Lee. First, for throat discomfort; then, head-to-toe hives; and finally, anaphylactic shock.

Lee said the family had two choices: One, to wait and hope Michael never has a lethal exposure to peanuts, a hold-your-breath option that breeds paranoia. Or they could weigh the risks and benefits of the new treatment and make an informed leap of faith.

“I don’t see this as exposing him to something dangerous,” Lee said. “I chose this treatment because the alternative is, what? To do nothing and be paranoid all the time?”

The science behind the treatment is like inoculation. For instance, flu shots contain minute amounts of viruses to protect people from influenza, and allergy shots of pollen-based solutions ease the symptoms of seasonal outdoor allergy sufferers.

Here’s the caveat: According to Mercy’s allergists, the peanut desensitization program comes with “significant risk of a serious allergic reaction, including hives, swelling, bronchospasm, difficulty breathing, loss of consciousness and shock, which may necessitate emergency treatment and hospitalization.” And, the unmentionable: risk of death.

Still, the pair of allergists running the program, Drs. Rubina Inamdar and Binita Mandal, believe they’ve developed an air-tight protocol to prevent harm from coming to the dozen or so children they treat. Over 18 months, the two painstakingly reviewed research and protocols of a handful of similar programs across the country.

MORE ALLERGIES

No one knows why food allergies – especially peanut allergies, considered the most dangerous – are growing at such a rapid pace. The Centers for Disease Control and Prevention reported that, from 1997 to 2011, food allergies grew in number by 50 percent from 3.4 percent to 5.1 percent of American children.

Scientists are vexed, and continue to study the problem. A predominant theory is that our lives have become so clean, our homes and hands so sanitized, that our immune systems are confused. They have trouble locating germs and bad actors to battle, and end up targeting substances like the signature ingredient in an American staple, the iconic peanut butter and jelly sandwich.

Other food allergies are triggered by milk, tree nuts, soy, wheat, shellfish and eggs, with eggs being the most common. Recently, buckwheat joined the list.

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