Peanuts allergy in atopic dermatitis patients, analysis of sensitization to molecular components

Čelakovská, Jarmila; Bukač, Josef; Vaňková, R.; Krejsek, Jan; Andrýs, Ctirad

doi:10.1080/09540105.2021.1911958

Cited by 3 publications

(2 citation statements)

References 48 publications

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“…However, the prevalence of sensitization, defined by a positive skin prick test (SPT) or detection of specific immunoglobulin class E (sIgE) to whole peanut extract in the general population of children, is estimated to be approximately 10%. The prevalence of sensitization to peanut is even higher in patients with atopic dermatitis or allergic respiratory disease, mainly due to sensitization to nonspecific and cross-reactive peanut proteins, such as Ara h8, resulting in mild symptoms such as oral allergy syndrome (OAS) or even tolerance to peanut [11,12]. Therefore, patient history is very important in the diagnosis of peanut allergy [1].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Anaphylaxis in Children Allergic to Peanuts

Petek¹,

Lajhar²,

Krašovec³

et al. 2023

Preprint

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Background and Objectives: Peanut allergy is the most common single cause of anaphylaxis in children. The risk factors for anaphylaxis in children with peanut allergy are not well defined. Therefore, we aimed to identify epidemiological, clinical and laboratory characteristics of children with peanut allergy that may predict the severity of allergic reaction and anaphylaxis. Materials and Methods: We conducted a cross-sectional study and included 94 children with peanut allergy. Allergy testing was performed, including skin prick testing and determination of specific IgE levels to peanut and its Ara h2 component. In case of discordance between patient history and allergy testing, an oral food challenge with peanut was performed. Results: Anaphylaxis, moderate and mild reactions to peanuts occurred in 33 (35.1%), 30 (31.9%) and 31 (33.0%) patients, respectively. The severity of the allergic reaction only weakly correlated (p = 0.04) with the amount of peanuts consumed. The median number of allergic reactions to peanut was 2 in children with anaphylaxis compared with 1 in other patients (p = 0.04). The median level of specific IgE to Ara h2 was 5.3 IU/ml in children with anaphylaxis compared to 0.6 IU/ml and 10.3 IU/ml in children with mild and moderate peanut allergy (p = 0.06). The optimal cutoff for distinguishing between anaphylaxis and a less severe allergic reaction to peanut was a specific IgE Ara h2 level of 0.92 IU/ml with 90% sensitivity and 47.5% specificity for predicting anaphylaxis (p = 0.04). Conclusions: Epidemiological and clinical characteristics of the patient cannot predict the severity of allergic reaction to peanut in children. Even standard allergy testing, including component diagnostics, is a relatively poor predictor of the severity of allergic reaction to peanuts. Therefore, more accurate predictive models including new diagnostic tools are needed to reduce the need for oral food challenge in most patients.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Anaphylaxis in Children Allergic to Peanuts

Petek¹,

Lajhar²,

Krašovec³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…However, the prevalence of sensitization, defined by a positive skin prick test (SPT) or the detection of specific immunoglobulin class E (sIgE) to whole peanut extract in the general population of children, is estimated to be approximately 10%. The prevalence of sensitization to peanuts is even higher in patients with atopic dermatitis or allergic respiratory disease, mainly due to sensitization to non-specific and cross-reactive peanut proteins, such as Ara h8, resulting in mild symptoms such as oral allergy syndrome (OAS) or even a tolerance to peanuts [ 11 , 12 ]. Therefore, patient history is very important in the diagnosis of peanut allergies [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Anaphylaxis in Children Allergic to Peanuts

et al. 2023

View full text Add to dashboard Cite

Background and Objectives: A peanut allergy is the most common single cause of anaphylaxis in children. The risk factors for anaphylaxis in children with a peanut allergy are not well defined. Therefore, we aimed to identify epidemiological, clinical, and laboratory characteristics of children with a peanut allergy that may predict the severity of the allergic reaction and anaphylaxis. Materials and Methods: We conducted a cross-sectional study and included 94 children with a peanut allergy. Allergy testing was performed, including skin prick testing and the determination of specific IgE levels to peanuts and their Ara h2 component. In case of discordance between patient history and allergy testing, an oral food challenge with peanuts was performed. Results: Anaphylaxis and moderate and mild reactions to peanuts occurred in 33 (35.1%), 30 (31.9%), and 31 (33.0%) patients, respectively. The severity of the allergic reaction was only weakly correlated (p = 0.04) with the amount of peanuts consumed. The median number of allergic reactions to peanuts was 2 in children with anaphylaxis compared to 1 in other patients (p = 0.04). The median level of specific IgE to Ara h2 was 5.3 IU/mL in children with anaphylaxis compared to 0.6 IU/mL and 10.3 IU/mL in children with mild and moderate peanut allergies (p = 0.06). The optimal cutoff for distinguishing between anaphylaxis and a less severe allergic reaction to peanuts was a specific IgE Ara h2 level of 0.92 IU/mL with 90% sensitivity and 47.5% specificity for predicting anaphylaxis (p = 0.04). Conclusions: Epidemiological and clinical characteristics of the patient cannot predict the severity of the allergic reaction to peanuts in children. Even standard allergy testing, including component diagnostics, is a relatively poor predictor of the severity of an allergic reaction to peanuts. Therefore, more accurate predictive models, including new diagnostic tools, are needed to reduce the need for oral food challenge in most patients.

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