Peanuts and vomiting - any experience?

[NerdyMama]

My 5-year-old daughter is violently sick within 2-3 hours of eating anything with peanuts as an ingredient e.g. peanut butter, but there are no other symptoms and traces of peanut are fine. She had a skin prick test when she was a toddler, and this was negative, but I remain worried about this as there is a family history of peanut allergy (extended family) and she had eczema as a baby, her brother has asthma. Our GP said that it's an intolerance vs allergy, but I'm so nervous about an allergy being overlooked and potentially worsening with exposure.

Does anyone else have experience of a peanut intolerance vs allergy?

My son is allergic to peanuts.. he vomited, red neck, lolled his eyes, went floppy.. showed up on skin prick test, high IgE levels. Also allergic to sesame, red itchy neck and vomiting but up to 48 hours later, showed up on one test, then didn't so we thought it had gone but when we worked out what the 48 vomiting was, it showed up again..

With peanuts, he has been exposed to peanuts twice more that we know of an he vomited the first time and nothing happened the third.

So.. well.... I would keep her away from peanuts. I would also consider asking for a referral to an immunologist and would be asking to GP to review her overall IgE levels and retesting for peanuts at a minimum.

I would ask for a referral skin prick testing. I don’t think peanut allergy is something you take a risk with. DS was referred for tests after itchy throat, red patches and then throwing up after eating satay which we insisted he tried even though he said he didn’t like it. This means you can be informed about what nuts do and don’t need to be avoided. DS 17 eats Nutella but he can tell if he’s ingested a peanut immediately as he will feel very ill and incapacitated and will make him need to vacate bowels quite suddenly. He carries an epi pen but most of his symptoms can be controlled with an antihistamine but you never know what his reaction may be next time. My fear is a 5 year old can’t necessarily convey their symptoms and each “episode” can bring on different reactions. DS had second episode when 15 and hadn’t had a severe reaction in between due to avoidance. He wasn’t aware he was having an episode and told teachers at school it wasn’t because he didn’t know what it actually felt like and was confused.

Thank you. I've made an appointment to see if I can get her re-referred for a skin prick test as a minimum. The one she had at age 2 was at an allergy clinic and was negative for all allergens tested, including peanuts, but I always wonder - such a coincidence that she reacts to something that happens to be a common allergen!

I definitely see the point that a 5-year-old won't necessarily articulate all symptoms, but my daughter happens to be quite tuned in to anything physical and will tell me even when she needs to scratch her nose!!!
So, the symptoms with peanut ingestion seem to be just abdominal pain and vomiting, a few hours after eating them (this only happens inadvertently and once a year, usually when travelling due to miscommunication/language barriers). It's a constant worry at the back of my mind though in case it IS an allergy vs intolerance and has the potential to worsen with age and future exposure.
Peanuts are avoided entirely at the moment other than the accidental episodes described (and we don't worry about anything that shows 'possible traces of nuts' on the ingredient list) and I tell school, childcare providers etc that she has a peanut allergy even though not confirmed.

My dd didn't develop a peanut allergy until she was four. She'd had peanuts lots of times before with no reaction at all.

My ds has oral allergy syndrome to peanuts. It means that he is actually allergic to birch pollen but the protein of that and peanuts are similar enough that if he eats peanuts it will give him a massive stomach ache and he will vomit.

We treat it with antihistamines and resting near a vomit bucket!

BUT he was followed by a pediatric allergist for years in order to establish this. He had multiple skin prick tests that he tested positive for the IgE blood test that he was positive for but then was negative on the higher levels of epitope testing. With a food challenge he reacted badly to the skin prick, felt sick but had no systemic progressing reaction, hence they concluded that he had oral allergy syndrome. Basically anytime his blood or a membrane in his body (so stomach lining/nasal lining) touches a peanut protein, that specific bit of him reacts with hives. But it doesnt travel around his body. His stomach breaking out in hives (so to speak) makes him vomit.
Here is a link that I found helpful

https://www.thermofisher.com/allergy/us/en/allergen-fact-sheets.html?allergen=peanut#:~:text=If%20you%20experience%20an%20itchy,Oral%20Allergy%20Syndrome%20(OAS).

this is not something to self diagnose..we had years of specialist help

Yes!
My 20month old had/s lots of non IgE-mediated allergies including the usual suspects like milk, and some the paediatric allergy team told us couldn't exist, including nuts. We gave him him nuts, within sbout 48 hours he would get watery dark diarrhoea 10x a day. Cut them out - 2 regular solid poos a day. Reintroduced two different types of nuts separately on different occasions - same reaction each time. Fixed again by removing from diet. Fish made him vomitty. He's grown out of fish vom, we are yet to retry nuts.

@Notasdesperate, that's interesting! I know another child who isn't allergic apparently but salmon makes him sick, and he's now outgrowing that at almost 5. I would say that I have a sensitive stomach (IBS) and have certain triggers for diarrhoea/upset stomach (sorry tmi!) and this also varies hormonally and depending on stress levels. Have you been advised to retry nuts at some point?

Interesting to hear about another fish-vomit reaction! Yes, as soon as possible they said, it didn't really make sense. We're just starting now with almonds.

I think a skin prick test only comes up positive if someone has been exposed before - you have to have had a primary exposure to develop a reaction for the test to detect. And they only detect IgE-mediated allergies.

I have nut allergy and have had all my life. I have the full anaphylaxis. Swelling, closed airway, hives, drop in blood pressure etc. My friend has violent sickness, stomach pain etc. She has an issue with all foods with a stone. So no olives, olive oil , nuts etc.

I'd say hers is severe intolerance rather than classic allergy but nasty all the same.

My dd tested negative on a skin prick test after her first reaction to peanut butter at 2 years old, which was relatively mild - hives, swelling of the face. We were told to go by observed reaction rather than skin prick test. Accidental exposure confirms she is now fully anaphylactic to peanut and has had to use her epipen, and blood test results are high. Unfortunately she now has other allergies too.