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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Allergy Reaction To Cashew-nuts, Nausea, Vomited Twice, Rashes And Hives Allover The Body, Gave Loratadine. Worried ?

My wife is currently have an allergy reaction to cashew nuts . Her symptoms are , nausea, already vomited twice, rashes and hives allover the body and nearly fainted when she was trying to walk back from the bathroom (about 10 steps from the stool). Her rashes started developing at about 10pm and now (2am) she said that she is just tired and has a upset stomach, (possibily having a fever). She is asleep now as I gave her some loratadine. Should her be submitted to an ER ? What is the chance that she might develop anaphylaxis ?
Tue, 27 Nov 2012
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Allergist and Immunologist,  's  Response
Hello,

Your wife has developed a moderate to severe allergic reaction given the symptoms of nausea, vomiting, generalised urticarial rash, near fainting episode. The last symptom is due to sudden histamine release and loss of blood pressure control that is defined as anaphylaxis.

So she had anaphylaxis and going to sleep is NOT a good sign.

Please call the Ambulance if she remains unresponsive and you are unable to feel her taking breaths or unable to get a pulse.

She may be truly asleep as some people get drowsy on antihistamines, but sedative antihistamines should only be given is such a setting in a hospital.

She definitely needs blood tests against the entire nut panel, but should be done after 4 weeks.

Even if the tests are inconclusive or borderline positive, she must AVOID ALL NUTS for life.

An emergency kit with Epipen, cetirizine, prednisolone and asthalin inhaler (if asthmatic) MUST be available to her or at the house at all times.



Best Wishes.
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Allergy Reaction To Cashew-nuts, Nausea, Vomited Twice, Rashes And Hives Allover The Body, Gave Loratadine. Worried ?

Hello, Your wife has developed a moderate to severe allergic reaction given the symptoms of nausea, vomiting, generalised urticarial rash, near fainting episode. The last symptom is due to sudden histamine release and loss of blood pressure control that is defined as anaphylaxis. So she had anaphylaxis and going to sleep is NOT a good sign. Please call the Ambulance if she remains unresponsive and you are unable to feel her taking breaths or unable to get a pulse. She may be truly asleep as some people get drowsy on antihistamines, but sedative antihistamines should only be given is such a setting in a hospital. She definitely needs blood tests against the entire nut panel, but should be done after 4 weeks. Even if the tests are inconclusive or borderline positive, she must AVOID ALL NUTS for life. An emergency kit with Epipen, cetirizine, prednisolone and asthalin inhaler (if asthmatic) MUST be available to her or at the house at all times. Best Wishes.