Investigation and diagnosis of lifethreatening allergies in childhood

  • P C Potter


Life-threatening allergies often present difficult diagnostic challenges to health practitioners managing children. They are a source of great anxiety to parents and children and require accurate assessment and careful management. In recent decades there has been a real increase in true food and drug allergies affecting children across the age spectrum, from well-nourished ones to those infected with HIV. Although the most severe life-threatening allergies in children most often result from food and drug hypersensitivities, severe allergic reactions with life-threatening consequences are also encountered after exposure to latex, insect venoms, vaccines, immunotherapy, certain aero-allergens and certain food and drug preservatives. In high-risk children life-threatening reactions may also follow exercise or exposure to cross-reacting allergens. The principle of taking a careful history, details of the events and exposure before the reaction and before embarking on blood tests or other investigations, applies to all life-threatening allergies. There are a number of useful new diagnostic tests for evaluating life-threatening reactions. These include nonspecific tests, such as the mast cell tryptase test, and specific tests, including the Immunocap radio-allergosorbent test (RAST), cellular activated sulphido-leukotriene release test (CAST), titrated specific skin-prick testing and controlled challenge tests. Assessment of risk, level of exposure, inadvertent exposure and prevention of subsequent reactions are important components of the comprehensive management of these children.


Journal Identifiers

eISSN: 1999-7671
print ISSN: 1994-3032