Ewan and Clark used a grading system for the severity of reaction shown by patients with allergy to peanuts or other nuts. This can help evaluate a specific episode and the impact of any interventions.
Symptoms During Reaction
Severity
Grade
none
nil
0
localized cutaneous erythema, urticaria, angioedema, oral pruritis
mild
1
generalized cutaneous erythema, urticaria, angioedema
2
(Grade 1 OR 2 reactions) AND (gastrointestinal symptoms OR rhinoconjunctivitis)
mild-to-moderate
3
mild laryngeal edema or mild asthma
moderate
4
pronounced dyspnea or hypotensive symptoms
severe
5
where:
• Mild laryngeal edema may present as voice change or tightening of the throat.
• Hypotensive symptoms may include light-headedness, collapse or loss of consciousness. I would think lightheadedness might be classed as Grade 4.
• I would imagine that a fatal reaction could be indicated as Grade 6.
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Specialty: Immunology/Rheumatology, Nutrition, Pedatrics
ICD-10: ,
