BACKGROUND: Although peanut allergy may recur, the frequency with which this occurs is unknown. OBJECTIVE: The goals of this study were to determine the rate of peanut allergy recurrence, identify risk factors for recurrent peanut allergy, and develop specific recommendations for the treatment of patients with resolved peanut allergy. METHODS: Children who outgrew peanut allergy were evaluated with questionnaires, skin tests, and peanut-specific IgE levels. Patients were invited to undergo a double-blind, placebo-controlled food challenge (DBPCFC) unless the history of a possible recurrence reaction was so convincing that a challenge would be potentially dangerous. RESULTS: Sixty-eight patients were evaluated. Forty-seven patients continued to tolerate peanut, of whom 34 ingested concentrated peanut products at least once per month and 13 ate peanut infrequently or in limited amounts but passed a DBPCFC. The status of 18 patients was indeterminate because they ate peanut infrequently or in limited amounts and declined to have a DBPCFC. After excluding 12 patients originally diagnosed with peanut allergy based solely on a positive skin prick test or peanut-specific IgE level, 3 of 15 patients who consumed peanut infrequently or in limited amounts had recurrences, compared with no recurrences in the 23 patients who ate peanut frequently ( P = .025). The recurrence rate was 7.9 (95% CI, 1.7% to 21.4%). CONCLUSION: Children who outgrow peanut allergy are at risk for recurrence, and this risk is significantly higher for patients who continue largely to avoid peanut after resolution of their allergy. On the basis of these findings, we now recommend that patients eat peanut frequently and carry epinephrine indefinitely until they have demonstrated ongoing peanut tolerance.
BACKGROUND: Although peanutallergy may recur, the frequency with which this occurs is unknown. OBJECTIVE: The goals of this study were to determine the rate of peanutallergy recurrence, identify risk factors for recurrent peanutallergy, and develop specific recommendations for the treatment of patients with resolved peanutallergy. METHODS:Children who outgrew peanutallergy were evaluated with questionnaires, skin tests, and peanut-specific IgE levels. Patients were invited to undergo a double-blind, placebo-controlled food challenge (DBPCFC) unless the history of a possible recurrence reaction was so convincing that a challenge would be potentially dangerous. RESULTS: Sixty-eight patients were evaluated. Forty-seven patients continued to tolerate peanut, of whom 34 ingested concentrated peanut products at least once per month and 13 ate peanut infrequently or in limited amounts but passed a DBPCFC. The status of 18 patients was indeterminate because they ate peanut infrequently or in limited amounts and declined to have a DBPCFC. After excluding 12 patients originally diagnosed with peanutallergy based solely on a positive skin prick test or peanut-specific IgE level, 3 of 15 patients who consumed peanut infrequently or in limited amounts had recurrences, compared with no recurrences in the 23 patients who ate peanut frequently ( P = .025). The recurrence rate was 7.9 (95% CI, 1.7% to 21.4%). CONCLUSION:Children who outgrow peanutallergy are at risk for recurrence, and this risk is significantly higher for patients who continue largely to avoid peanut after resolution of their allergy. On the basis of these findings, we now recommend that patients eat peanut frequently and carry epinephrine indefinitely until they have demonstrated ongoing peanut tolerance.
Authors: Corinne A Keet; Pamela A Frischmeyer-Guerrerio; Ananth Thyagarajan; John T Schroeder; Robert G Hamilton; Stephen Boden; Pamela Steele; Sarah Driggers; A Wesley Burks; Robert A Wood Journal: J Allergy Clin Immunol Date: 2011-11-30 Impact factor: 10.793
Authors: Stephanie A Leonard; Hugh A Sampson; Scott H Sicherer; Sally Noone; Erin L Moshier; James Godbold; Anna Nowak-Węgrzyn Journal: J Allergy Clin Immunol Date: 2012-08 Impact factor: 10.793