We do not have adequate studies to state the general risk of chickpea allergy among children with peanut allergy. Peanut is a legume and it shares similar proteins with many other beans. However, in a U.S. study performed many years ago, only 5 percent of children with a peanut allergy had allergic reactions to other beans tested.

A tricky problem is that if you use blood or skin tests to beans for a person with a peanut allergy, about half the time the tests are positive even though 95 percent of the patients can eat the beans. The tests are affected by immune responses to shared bean proteins that are not important when it comes to allergic reactions.

Studies of chickpea and lentil allergy emanating from Mediterranean countries do note a high correlation of allergic reactions among pea, chickpea and lentil. Over two-thirds of children reactive to one of these three, reacted to another of the three. However, peanut allergy was uncommon in these children.

It appears that if a child with peanut allergy has already been tolerating peas, there is a much lower chance of having allergy to chickpea. Conversely, if peas caused a reaction, the risk of chickpea and lentil allergy is quite high.

Individual advice may vary, but if chickpea was already eaten and tolerated, there would be no reason to avoid it because of a peanut allergy. Lastly, a positive allergy test to chickpea in a person with peanut allergy does not prove an allergy and a medically supervised feeding (e.g. a food challenge) may be warranted.

Dr. Scott Sicherer is Chief of the Division of Allergy and Immunology of the Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York. Together with Dr. Hemant Sharma, he writes “The Food Allergy Experts” column in the American Edition of Allergic Living magazine. Questions submitted below will be considered for answer in the magazine.

IN LABS in universities and hospitals across North America and Europe, these are exciting and competitive times in allergy research. There are strong prospects for a vaccine that would significantly increase a peanut-allergic individual’s tolerance to the dread legume. And, while farther off into the future, scientists are speaking with cautious optimism about the possibility of one day preventing allergic responses altogether.

At the forefront of the research is Xolair, a drug that U.S. specialists in allergic science are now testing on peanut-allergic individuals, while Canadian researchers prepare to do the same in parallel studies. Xolair is injected as a vaccine and has already proved highly successful in a slightly different application in the treatment of asthma. The hope is that it will do the same in peanut allergy.

Yet Xolair is but one of the strategies on the drawing board. In November 2004, California’s Stanford University announced that allergic dogs had remarkably tolerated handfuls of ground peanuts after a course of a vaccine that employs heat-killed bacteria mixed with peanut protein, while researchers at the world-renowned Jaffe Food Allergy Institute at the Mount Sinai School of Medicine in New York found success in mice with a different dead-bacteria-based vaccine, this one employing the common E.coli.

“I think as every day goes by, you could say that there is more and more in the pipeline in terms of trying to treat food allergy and peanut allergy in particular,” says Dr. Scott Sicherer, associate professor of pediatrics at the Jaffe Institute. “There are a lot of strategies that are being looked at simultaneously.”

These developments can’t come quickly enough. In May, 2004, Dr. Hugh Sampson, the director of the Jaffe Institute and Sicherer’s colleague, published a report analyzing studies over five years and concluded that ?nearly 4 per cent of Americans are afflicted with food allergies.? That is a rate of allergy far higher than had been found before 1997. In Canada, the percentage incidence is estimated to be similar, if slightly less. Sampson also found that peanut allergy alone…

for the rest of this article, see the Spring 2005 issue of Allergic Living magazine.
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IT WASN’T until Sandra Schwartz was on a camping trip in Northern Ontario in August 2005 that she felt the full force of the fear. Just a couple of days earlier, the 36-year-old Ottawa resident had been lying in an emergency room, experiencing her second-ever reaction to shellfish after eating a plate of shrimp.

Unlike the minor reaction she’d had a year before, when she turned red and her face swelled, this one was full-blown anaphylaxis: Schwartz’s entire body turned crimson red and covered in hives, her heart raced as she grew lightheaded and dizzy, and her face swelled beyond recognition. But the food didn’t just set off a dramatic physical response, it also triggered a psychological tidal wave.

“They always talk about that feeling of impending doom, and I had it times 10,” says Schwartz. “The doctors were saying I was OK, but I said, ‘I feel like I’m going to die. Please don’t let me die.’ ”

Though she had yet to realize it, that was the night Schwartz’s fear of food began. The next day, thinking she was well enough to travel, Schwartz left on a planned camping trip with her boyfriend.

As they drove along the increasingly remote highways, the “what ifs” began to creep like tendrils into her psyche: What if I react again? What if medical help can’t get to me on time?

And, because Schwartz had been diagnosed with a shellfish allergy a year earlier, but didn’t understand that she was supposed to avoid it altogether, she had continued to eat shellfish. In fact, only a month before, she had eaten a plate of shrimp without incident.

As a result, she didn’t fully believe that it could have triggered such a massive reaction. That raised another terrifying question: If it wasn’t the shrimp, what was it? Maybe it was fruit. Or wheat. Or something else. Suddenly, every food was suspect, and Schwartz became terrified to eat.

A couple of days later, her panic peaked. “We were in the middle of nowhere, I was chewing a piece of gum, and I started not being able to breathe.” Schwartz thought it was another reaction, so her boyfriend drove full tilt to the next town. Once in the hospital parking lot, Schwartz realized it wasn’t a reaction that she had experienced. It was a major panic attack.

“I just sat crying in the car. That’s when we realized that there’s a real psychological element to this.”

The couple cut the trip short. Still, Schwartz only felt safe eating cereal and pasta. She saw an allergist and got retested (once again, shellfish was the allergen), and tentatively added a few more foods to her diet, but the fear persisted.

By the time she got married three months after that camping trip, Schwartz joked to friends that allergies were the best pre-wedding weight loss plan around. Feeling like every bite was potentially lethal, she had lost over 20 pounds. “Every time I ate, it was like taking a plunge out of an airplane,” she says. “And I wasn’t sure if the parachute was going to open or not.”