Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–Sponsored Expert Panel

Togias, Alkis; Cooper, Susan; Acebal, Maria L.; Assa’ad, Amal; Baker, James R.; Beck, Lisa A.; Block, Julie; Byrd‐Bredbenner, Carol; Chan, Edmond S.; Eichenfield, Lawrence F.; Fleischer, David M.; Fuchs, George J.; Furuta, Glenn T.; Greenhawt, Matthew; Gupta, Ruchi S.; Habich, Michele; Jones, Stacie M.; Keaton, Kari; Muraro, Antonella; Plaut, Marshall; Rosenwasser, Lanny J.; Rotrosen, Daniel; Sampson, Hugh A.; Schneider, Lynda C.; Sicherer, Scott H.; Sidbury, Robert; Spergel, Jonathan M.; Stukus, David R.; Venter, Carina; Boyce, Joshua A.

doi:10.1016/j.pedn.2016.12.006

Cited by 35 publications

(52 citation statements)

References 29 publications

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“…OFCs are also used in research, even if a positive result is expected, with the aim of broadening knowledge on the pathophysiology of PNA, to determine a threshold for reactivity, or evaluate the effects of novel immunotherapies for PNA. Another indication for peanut FC applies to infants following the new recommendations based on the results of the LEAP study …”

Section: Oral Food Challengementioning

confidence: 99%

Peanut allergy diagnosis: Moving from basic to more elegant testing

Krogulska

Wood

2020

Pediatric Allergy Immunology

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Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide.Peanut allergy is particularly widespread in the younger population and affects almost ¼ of children with food allergy (FA). 1 Although PNA tends to develop in early life, it resolves in only 20% of children. 2 The overall prevalence of PNA is estimated as 0.4% in Europe and 0.6% in the United States. 3,4 The frequency of PNA by self-report is higher in the United States (1.2% to 8% of children) 5,6 than in Europe (from 0.5% to 2.5%). 3,7 Studies based on oral food challenge (OFC) have estimated the prevalence of PNA in Europe as 0.2%-1. 6%, 8,9 in Australia to be 3% at 12 months of age and 1.9% at 4 years. 10 On the basis of stringent criteria (peanut IgE > 14 kUA/L and prescribed epinephrine autoinjector), its prevalence among US school children was found to be 2%. 11Overall, the prevalence of PNA appears to be increasing, especially in developed countries. A large telephone-based survey found rates of PNA in US children rising from 0.6% in 1997 to 1.2% in 2002 and 2.1% in 2007. 2,5,6 Similar trends have been reported from the UK 8 ; however, studies from Canada 12 and a newer one from the UK suggest the prevalence has stabilized. 13 Peanut allergy also represents the most common cause of anaphylactic reactions in children, with its incidence increasing between five and sevenfold over the past 10 years. 14,15 It accounts for the majority of severe food-related allergic reactions and has the highest lifetime risk for both anaphylaxis and anaphylaxis mortalities. 16 Exposure to even trace amounts of peanut can induce a serious reaction, including anaphylactic shock.These facts result in significant effects on quality of life of patients and their families. In addition, the widespread distribution of peanuts (PN) in food products not only complicates their avoidance but also increases the risk of allergic reactions through accidental consumption. 2,16 Hence, an accurate diagnosis of PNA is vital. However, while the diagnosis is often obvious just based on the clinical history, in many cases it is far less clear given the imperfect nature of food allergy Abstract Peanut allergy (PNA) is an IgE-mediated immune disorder, which merits particular attention due to its impact on the health and quality of life of millions of patients worldwide. PNA tends to develop in early life and resolves in only 20% of peanutallergic children. It accounts for the majority of severe food-related allergic reactions.An accurate diagnosis of PNA is vital. In this review, we present the approach to the diagnosis of peanut allergy, starting from the history and proceeding to measures of overall sensitization and then to component-resolved diagnostics and oral food challenges as indicated. Additional testing in development includes basophil activation testing and determination of epitopes for peanut-allergic responses. Based on the literature, stepwise approaches and...

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Section: Oral Food Challengementioning

confidence: 99%

Peanut allergy diagnosis: Moving from basic to more elegant testing

Krogulska

Wood

2020

Pediatric Allergy Immunology

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“…The prevalence of peanut allergy (PA) among children has risen significantly over the past decade [1,2]. However, in Asia, the prevalence of PA has remained relatively low in comparison to Western countries-0.22% in Korea, 0.1%-0.3% in Singapore, 0.43% in the Philippines versus 1.50% in the UK, 1.40% in the US, and 3% in Australia [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

A 5-year retrospective review of children with peanut allergy in the largest paediatric hospital in Singapore

Lee

Saffari

Loh

et al. 2020

Asia Pacific Allergy

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Background: The prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children. Objective: To describe the demographic characteristics and clinical features of children with PA. Methods: This is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results. Results: There were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13-39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy-75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma. Conclusion: This is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.

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“…41 In the United States, the NIAID-sponsored guidelines were based on the specific inclusion criteria and screening schema of the LEAP study, recommending introduction of peanut-containing foods as early as 4 to 6 months for infants with severe eczema or egg allergy and at about 6 months for infants with milder eczema, and further recommending screening for the highest-risk infants before introduction ( Fig 5). 42 Other countries have taken a different approach. 43,44 For example, Australia released guidelines after a 2016 Infant Feeding Summit recommending that infants begin introducing solid foods at around 6 months (but not before 4 months) and that all infants should be given allergenic solid foods including peanut butter, cooked egg, dairy, and wheat products in the first year of life, irrespective of risk category.…”

Section: Prevention Of Food Allergymentioning

confidence: 99%

“…Summary of the 3 addendum guidelines to be used as a quick reference. Used with permission from Togias et al42 …”

mentioning

confidence: 99%

Advances in food allergy in 2017

Keet

Allen

2018

Journal of Allergy and Clinical Immunology

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This review highlights research and policy advances in food allergy that were published in 2017 in the Journal and beyond. In 2017, many important studies on the treatment of food allergy were published, bringing us ever closer to a standardized treatment for food allergy. Other important advancements included research into other management strategies, including thresholds for avoidance, management of food allergies in schools, and development of new guidelines for prevention of food allergy. There were several important epidemiologic studies helping us understand the phenotypes of allergic disease, and new hypotheses were proposed for how best to prevent food allergy. Finally, there was a welcome increased attention to non-IgE-mediated food allergies.

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Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases–Sponsored Expert Panel

Cited by 35 publications

References 29 publications

Peanut allergy diagnosis: Moving from basic to more elegant testing

Peanut allergy diagnosis: Moving from basic to more elegant testing

A 5-year retrospective review of children with peanut allergy in the largest paediatric hospital in Singapore

Advances in food allergy in 2017

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