BACKGROUND: Understanding predictors of clinical remission would assist in clinical management of peanut allergy. OBJECTIVE: We sought to determine the early clinical predictors of peanut allergy remission using a longitudinal cohort of young children with peanut allergy. METHODS: Consecutive patients less than 2 years of age with peanut allergy were identified on the basis of skin prick test (SPT) wheal size of 95% positive predictive value or greater. Baseline SPT responses to peanuts, tree nuts, and sesame and serum peanut-specific IgE antibody levels were documented, and follow-up studies were conducted at 1- to 2-year intervals for up to 8 years. Peanut food challenges were performed when SPT responses decreased to less than the 95% positive predictive value for peanut allergy. RESULTS: SPT wheal diameters to peanut extract of 6 mm or greater (hazard ratio, 2.16; 95% CI, 1.23-3.786; P = .008) and peanut-specific IgE antibody of 3 kUA/L or greater (hazard ratio, 2.74; 95% CI, 1.13-6.61; P = .025) before the age of 2 years were independent predictors of persistent peanut allergy. Mean SPT wheal diameters of nonremitters increased (r = 0.31, P < .001), whereas those of remitters decreased (r = -0.26, P = .002) between 1 and 4 years of age. Twenty-one percent of young children with peanut allergy became clinically tolerant by age 5 years. CONCLUSIONS: Remission of peanut allergy can be predicted by low levels of IgE antibodies to peanut in the first 2 years of life or decreasing levels of IgE sensitization by the age of 3 years.
BACKGROUND: Understanding predictors of clinical remission would assist in clinical management of peanutallergy. OBJECTIVE: We sought to determine the early clinical predictors of peanutallergy remission using a longitudinal cohort of young children with peanutallergy. METHODS: Consecutive patients less than 2 years of age with peanutallergy were identified on the basis of skin prick test (SPT) wheal size of 95% positive predictive value or greater. Baseline SPT responses to peanuts, tree nuts, and sesame and serum peanut-specific IgE antibody levels were documented, and follow-up studies were conducted at 1- to 2-year intervals for up to 8 years. Peanut food challenges were performed when SPT responses decreased to less than the 95% positive predictive value for peanutallergy. RESULTS: SPT wheal diameters to peanut extract of 6 mm or greater (hazard ratio, 2.16; 95% CI, 1.23-3.786; P = .008) and peanut-specific IgE antibody of 3 kUA/L or greater (hazard ratio, 2.74; 95% CI, 1.13-6.61; P = .025) before the age of 2 years were independent predictors of persistent peanutallergy. Mean SPT wheal diameters of nonremitters increased (r = 0.31, P < .001), whereas those of remitters decreased (r = -0.26, P = .002) between 1 and 4 years of age. Twenty-one percent of young children with peanutallergy became clinically tolerant by age 5 years. CONCLUSIONS: Remission of peanutallergy can be predicted by low levels of IgE antibodies to peanut in the first 2 years of life or decreasing levels of IgE sensitization by the age of 3 years.
Authors: Lisa M Stutius; William J Sheehan; Pitud Rangsithienchai; Apinya Bharmanee; Jordan E Scott; Michael C Young; Anahita F Dioun; Lynda C Schneider; Wanda Phipatanakul Journal: Pediatr Allergy Immunol Date: 2010-12 Impact factor: 6.377
Authors: Brian P Vickery; Jelena P Berglund; Caitlin M Burk; Jason P Fine; Edwin H Kim; Jung In Kim; Corinne A Keet; Michael Kulis; Kelly G Orgel; Rishu Guo; Pamela H Steele; Yamini V Virkud; Ping Ye; Benjamin L Wright; Robert A Wood; A Wesley Burks Journal: J Allergy Clin Immunol Date: 2016-08-10 Impact factor: 10.793