Asia Pac Allergy.  2015 Jul;5(3):170-176. 10.5415/apallergy.2015.5.3.170.

Repeat oral food challenges in peanut and tree nut allergic children with a history of mild/moderate reactions

• Wainstein
• Saad RA

• KMID: 2397047
• DOI: http://doi.org/10.5415/apallergy.2015.5.3.170

Abstract

BACKGROUND
In peanut and tree nut allergic children a history of anaphylaxis is associated with subsequent severe reactions.
OBJECTIVE
We aimed to prospectively rechallenge peanut and tree nut allergic children with a history of mild/moderate reactions to assess their allergy over time.
METHODS
In this cohort study peanut and tree nut allergic children with a history of mild/moderate reactions during a controlled oral challenge were invited to have a follow-up oral challenge to the same food at least 1 year later.
RESULTS
Twenty-six children participated in the study. The mean time interval between the first and second challenge for all participants was 35.5 months. Peanut or tree nut allergy resolved in 38.5% of participants. Those with persistent peanut or tree nut allergy showed a decrease in their reaction threshold and/or increased severity in 81% of cases. There were no demographic features or skin test results that were predictive of changes in severity over time.
CONCLUSION
Peanut and tree nut allergic children with a history of mild/moderate reactions who remained allergic demonstrated a high rate of more severe reactions and/or reduced thresholds upon rechallenge over a year later, however, the rate of resolution of allergy in this group may be higher than previously reported.

Keyword

Peanut Hypersensitivity; Nut Hypersensitivity; Anaphylaxis; Child

MeSH Terms

Anaphylaxis
Arachis*
Child*
Cohort Studies
Follow-Up Studies
Humans
Hypersensitivity
Nut Hypersensitivity
Nuts*
Peanut Hypersensitivity
Prospective Studies
Skin Tests
Trees*

Figure

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  Fig. 1 Grouping of study subjects.

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