Various scenarios
| Mild functional restriction | Moderate functional restriction | Severe functional restriction |
|---|---|---|
| A 7 year old boy has hay fever and during the hay fever season takes regular antihistamines and steroid nose drops to control his itchy watery eyes and runny nose. Last Spring his lips swelled up dramatically when he ate an apple. Because of this his parents and GP were worried that he might develop anaphylaxis. He was prescribed an Epipen, advised not to eat apples and referred to the Consultant Allergist for tests. The Consultant diagnosed hay fever and oral allergy syndrome that explained the lip swelling from eating apples.
He is not at risk of anaphylaxis because he has oral allergy syndrome although he does have a food allergy to apples, he does not need to carry an Epipen |
A 3 year old girl developed lip swelling and hives every time she ate dairy products from the age of 9 months. Each episode of lip swelling and hives was followed by a flare up of her otherwise mild eczema. Her mother cut out dairy from her diet. When she was 12 months old she had a similar reaction to peanut butter. The GP prescribed an Epipen and advised her to completely avoid milk and peanuts and referred her to a specialist. She had skin prick testing by the specialist when she was 18 months old and skin prick tests to cow’s milk and peanut were positive. She had anaphylactic shock after eating a pie when she was 2. Her faced swelled up, she was blotchy and sweaty and ‘not all there’. Her mother used the Epipen and by the time she got to A&E 15 minutes later she had almost recovered. She was observed for 4 hours and sent home with tablets. She has not had anaphylaxis since. She attends nursery for half days only because of her allergies and the nursery staff have had Epipen training to accommodate her. Her parents and grandparents are the only people who cook for her. She will be having a food challenge test soon because her skin prick tests show that she is growing out of her cow’s milk allergy.
She remains at risk of anaphylaxis from her peanut allergy. She is in the moderate category because she is at risk of anaphylaxis due to food allergy but she does not have severe asthma and has not been admitted to PICU. |
A 5 year old girl developed lip swelling and hives when she ate cow’s milk yoghurt at age 9 months. Her brother has a food allergy so her mother knew she should stop giving her dairy and she substituted soy products. The little girl reacted similarly to soy products and goats milk. Each episode of lip swelling and hives was followed by a flare up of her otherwise mild eczema. She then had anaphylactic shock after eating home made cod and potato when she was 12 months old. She was treated in A&E and admitted over night. 2 weeks later, she had skin prick tests that showed she was allergic to cow’s milk, goat’s milk, soy, lentils and fish. She has had anaphylactic shock approximately once a year since then. She was diagnosed with asthma 6 months ago and was admitted to PICU 3 months ago with anaphylaxis after eating potato chips fried in oil that had been previously used to fry fish.
This little girl has a severe functional restriction because she has 3 or more specific food allergies. In most cases the award duration for a child like this should be to age 8 but she has been admitted to PICU and will need more time to learn how to manage her medication as well as avoidance so her award duration should be to age 12. |
