Allergy

A 4 year old boy with a known peanut allergy and asthma develops wheezing and difficulty breathing after eating a chocolate. He has no rash or angioedema, but feels a bit dizzy. What would be your first step in treatment?

A 4 month old formula fed baby has ongoing problems with mild eczema, colic and straining when passing stool. The mother is concerned that he may be allergic to cow’s milk as his older brother had similar symptoms. What would be your next step?

A one year old boy presents with two episodes of lip swelling on eating scrambled egg. The boy has a background of eczema, as does his mother. He can eat the other common food allergens including cow’s milk, wheat, fish, shellfish, sesame, peanut and tree nuts without reaction. He also seems to be able to tolerate egg as an ingredient in cake. How will you investigate this patient?

A 8 year old girl is referred from the GP as a blood test for specific IgE levels to peanut were found to be positive. On taking your allergy focused history, you identify that there is no history of atopy in the child or the family and she eats peanut on a regular basis. She doesn’t exclude any foods from the diet and tolerates all other the common food allergens (milk, egg, wheat, fish, shellfish, soya, sesame, tree nuts). What advice do you give?