Fear of being "different," embarrassed, isolated or teased drives teens with potentially fatal food allergies to eat problem foods anyway, and to forgo carrying life-saving injectable epinephrine, according to results of a small study led by investigators at the Johns Hopkins Children's Center.

In a study of 20 teens with severe food allergies, nine reported intentionally eating foods to which they are allergic. Among 13- to 16-year-olds, only half reported always carrying an injectable epinephrine, while only one-third of those over 16 said they carried the life-saving drug at all times.

"We are seeing more risky behaviors than we thought we would, and it's troubling," said investigator Hemant Sharma, an allergist at the Johns Hopkins Children's Center.

Other reasons cited for the risk taking included annoyance with food restrictions, lack of good food labeling, fashion concerns and the inconvenience of carrying an epi-pen. Children and teens who were aware of and sensitive to life-threatening reactions were more likely to carry epinephrine at all times.

"The bad news for pediatricians and parents is that children and teens with severe food allergies are doing things that put them at risk for severe, sometimes fatal, reactions," said study investigator Hemant Sharma, an allergist at the Johns Hopkins Children's Center. "The good news is [that] making patients aware of the grave threat of anaphylaxis may steer them away from unnecessary risks."

Senior investigator on the study is Robert Wood, director of Allergy and Immunology at Johns Hopkins Children's Center.

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