A Link Between Asthma and Peanut Allergies?

Parents of children with asthma can feel helpless when they watch their child gasp for air, unable to supply his or her body with the oxygen it needs. It’s heartbreaking at best and downright scary at worst.

This scenario often means an immediate trip to the doctor, urgent care center or hospital Emergency Room for treatment with a nebulizer or inhaler and discussions about whether this reaction was caused by asthma.

“Asthma is the result of muscles in the airways constricting and the release of mucous to protect the lungs from something the body sees as dangerous,” said Viviana Sirven, M.D., an allergist affiliated with West Kendall Baptist Hospital.

For many asthma sufferers, those muscles react to allergens, such as mold, dust mites and pollen. Yet new research by a Dayton Children’s Hospital pulmonologist is prompting discussion about whether food allergies, especially to peanuts, may play a role in asthma.

Researchers looked at 1,517 children’s charts from a pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio. They found that 44 percent of those patients had undergone testing for peanut allergies at some point and 22 percent had tested positively. The researchers were surprised that more than half of those who tested positively didn’t know they were sensitive or allergic to peanuts. The research stops short of linking peanut allergies to asthma, but concludes that children with asthma should undergo testing for peanut sensitivity.

“Parents need to be careful about drawing conclusions from these types of studies,” Dr. Sirven warned. “Whether a test shows a child has a sensitivity or allergy to peanuts really doesn’t matter without the presence of a known reaction. Many kids test positive for this type of allergy and tolerate peanuts without any reaction.”

Dr. Sirven says that in addition to anaphylaxis, a life-threatening allergic reaction, a tell-tale sign of a food allergy often shows up on the skin in the form of eczema or hives. “When parents see that type of reaction after their child has been exposed to peanuts, we screen that child for allergies, but testing without the presence of symptoms doesn’t give us a clear picture of what might be going on.”

Baptist Health Medical Group physician Javier Hiriart, M.D., agrees. “The most important factor in determining whether allergies are present is a reaction to a substance or food,” he said.

Dr. Hiriart, from Baptist Health Primary Care Family Medicine Center at West Kendall Baptist Hospital, says that if asthma symptoms – coughing, wheezing and excessive mucous – are present, along with unexplained repetitive rashes or hives, screening for allergies, including food allergies, may be a good idea and help to guide treatment.

“With asthma management, our main concern is knowing the triggers of it, so we can minimize attacks,” he said. “We have seen evidence that patients who are allergic to many different substances are prone to more severe asthma attacks, but more research is needed to draw a conclusive link between peanut allergies and asthma.”

Following the release of this latest research, the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology issued statements against what they call “indiscriminate testing” for peanut sensitivity.

Dr. Sirven and Dr. Hiriart believe this type of testing could lead to over diagnoses of peanut allergies and overshadow the necessity to manage a child’s asthma.

“Children who need to carry inhalers for their asthma will now be carrying epinephrine injectors for a peanut sensitivity that may never cause a reaction,” Dr. Sirven said. “If asthma is affecting the child’s health and quality of life, parents should definitely bring that to their doctor’s attention for proper treatment. But, asthma doesn’t mean there’s a food allergy, too.”

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