Natural Course and Prognostic Factors of Immediate-Type Peanut Allergy in Children

2021 ◽  
pp. 1-5
Author(s):  
Minyoung Jung ◽  
Hye-In Jeong ◽  
Yechan Kyung ◽  
Su Kyung Kim ◽  
Ju Suk Lee ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Peanut Allergy ◽  
Challenge Test ◽  
Food Challenge ◽  
Specific Ige ◽  
Natural Course ◽  
Cox Proportional Hazard ◽  
Sige Level ◽  
Tertiary Hospitals ◽  
History Of

<b><i>Background:</i></b> Predicting food allergy resolution is essential to minimize the number of restricted foods in children. However, there have been no studies on the natural history of peanut allergy (PA) in Korea. <b><i>Objective:</i></b> This study aimed to evaluate the natural course and prognostic factors of immediate-type PA in children till the age of 10 years. <b><i>Methods:</i></b> We retrospectively collected data of 122 children who developed PA before 60 months of age from 3 tertiary hospitals in Korea. Diagnosis and resolution of PA was defined as an oral food challenge test or a convincing history of symptoms within 2 h after peanut ingestion. The prognostic factors for resolution of PA were identified using the Cox proportional hazard model. <b><i>Results:</i></b> The median (interquartile range) age at diagnosis was 2.0 (1.3–3.0) years. Among the 122 children, PA resolved in 18 (14.8%) children. The level of peanut-specific IgE (sIgE) at diagnosis in the persistence group was significantly higher than that in the resolution group (<i>p</i> = 0.026). The probabilities of resolution of PA were 10.3% and 32.8% at the ages of 6 and 10 years, respectively. A peanut-sIgE level ≥1 kU/L at diagnosis was significantly associated with persistent PA (hazard ratio, 5.99; 95% confidence interval, 1.89–18.87). <b><i>Conclusions:</i></b> Only 10.3% of our patients had a probability of developing spontaneous resolution of PA by 6 years of age. Peanut-sIgE levels ≥1 kU/L at diagnosis were associated with the persistence of PA.

Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

2020 ◽  
Vol 41 (5) ◽  
pp. 336-340
Author(s):  
Yasmin Hamzavi Abedi ◽  
Cristina P. Sison ◽  
Punita Ponda
Keyword(s):  
Retrospective Chart Review ◽  
Clinical History ◽  
Specific Ige ◽  
Exact Test ◽  
Ara H 1 ◽  
Sige Level ◽  
History Of ◽  
Laboratory Procedures ◽  
Ige Mediated ◽  
The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

scholarly journals Specific IgE for Fag e 3 Predicts Oral Buckwheat Food Challenge Test Results and Anaphylaxis: A Pilot Study

2018 ◽  
Vol 176 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Noriyuki Yanagida ◽  
Sakura Sato ◽  
Nobuyuki Maruyama ◽  
Kyohei Takahashi ◽  
Ken-ichi Nagakura ◽  
...  
Keyword(s):  
Pilot Study ◽  
Challenge Test ◽  
Food Challenge ◽  
Specific Ige ◽  
Test Results ◽  
Food Challenge Test

scholarly journals A Case of α-Gal-Unrelated Red Meat-Induced Urticaria Treated by Omalizumab

2021 ◽  
pp. 437-440
Author(s):  
Makoto Kondo ◽  
Yoshiaki Matsushima ◽  
Shohei Iida ◽  
Ai Umaoka ◽  
Takehisa Nakanishi ◽  
...  
Keyword(s):  
Chronic Urticaria ◽  
Challenge Test ◽  
Healthy Woman ◽  
Food Challenge ◽  
Red Meat ◽  
Meat Allergy ◽  
Red Meat Allergy ◽  
History Of ◽  
Food Challenge Test ◽  
Repeatability Test

A 70-year-old healthy woman was referred to our hospital for chronic urticaria. She did not have a history of allergy, asthma, and rhinitis. She was initially diagnosed with α-gal-related urticaria based on an episode of delayed-type urticaria after eating red meat. The results of the intracutaneous allergen test for beef and pork were negative. Fluorenzyme immunoassays specific for IgE against α-gal, beef, and pork were also negative. She was diagnosed with an α-gal-unrelated red meat allergy following the reproduction of urticaria by a food challenge test. The patient was unresponsive to several drugs, including antihistamines or immunosuppressants. However, omalizumab administration suppressed her symptoms. <b><i>Key Clinical Message:</i></b> The diagnosis of red meat allergy may require a repeatability test by consuming red meat even though serum α-gal IgE antibody might be negative. The α-gal-unrelated red meat urticaria may be responsive to omalizumab.

scholarly journals The Effect of Birch Pollen Immunotherapy on Apple and rMal d 1 Challenges in Adults with Apple Allergy

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 519 ◽  
Author(s):  
Johanna van der Valk ◽  
Birgit Nagl ◽  
Roy Gerth van Wljk ◽  
Barbara Bohle ◽  
Nicolette de Jong
Keyword(s):  
Skin Prick Test ◽  
Challenge Test ◽  
Birch Pollen ◽  
Food Challenge ◽  
Specific Ige ◽  
P Value ◽  
Double Blind ◽  
P Values ◽  
Prick Test ◽  
Bet V 1

Background: A proportion of patients allergic to birch pollen are also allergic to pit fruit. The objective of this study was to investigate the effect of immunotherapy with birch pollen on birch-pollen-related apple allergy. Method: Patients with birch pollen immunotherapy underwent a skin-prick test with birch pollen, apple and rMal d 1, global assessments and nasal challenges with birch pollen, open food challenge with apple and a double-blind, placebo-controlled test with rMal d 1 at the start of and during the immunotherapy. Measurements of specific IgE in response to Bet v 1 and rMal d 1 and IgG4 in response to Bet v 1 and rMal d 1 took place. Results: Six of eight patients demonstrated an improvement of nasal challenge test results and all patients improved on global assessment during the immunotherapy. The median oral dose of apple required to elicit a reaction increased but was not statistically significant. The patients showed a decrease in skin-prick test values in response to birch pollen (1.05 to 0.36), apple (0.78 to 0.25) and rMal d 1 (0.51 to 0.10) with p-values of 0.04, 0.03 and 0.06, respectively and a decrease of specific IgE in response to Bet v 1 (10.66 kU/L to 5.19 kU/L) and rMal d 1 (0.99 to 0.61 kU/L) with p-values of 0.01 and 0.05, respectively. Only the median specific IgG4 value to Bet v 1 increased from 0.05 to 1.85 mg/L (p-value of 0.02) and not to IgG4 rMal d 1 (0.07 to 0.08 kU/L). Conclusion: The beneficial effects of immunotherapy for birch pollen were accompanied by a limited effect on apple allergy.

The natural history of peanut allergy in young children and its association with serum peanut-specific IgE

2000 ◽  
Vol 137 (6) ◽  
pp. 749-755 ◽  
Author(s):  
Timothy K. Vander Leek ◽  
Andrew H. Liu ◽  
Kay Stefanski ◽  
Betty Blacker ◽  
S.Allan Bock
Keyword(s):  
Natural History ◽  
Young Children ◽  
Peanut Allergy ◽  
Specific Ige ◽  
History Of

scholarly journals White paper on peanut allergy: treatment pathway

2021 ◽  
Author(s):  
Ludger Klimek ◽  
Lars Lange ◽  
Lea Alexandra Blum ◽  
Felix Klimek ◽  
Katja Nemat ◽  
...  
Keyword(s):  
Peanut Allergy ◽  
Care Pathway ◽  
Incidental Finding ◽  
Therapeutic Option ◽  
Skin Prick Testing ◽  
Treatment Algorithm ◽  
Specific Ige ◽  
White Paper ◽  
Double Blind ◽  
History Of

Summary Background Peanuts are a member of the legume family (botanical family Leguminosae) and peanut allergies are the most common cause of food anaphylaxis in many countries. The prevalence of peanut allergy is increasing. Methods Experts from Germany and Austria performed a standardized literature search and published their consensus recommendations in a White Paper on Peanut Allergy, which this care pathway is based upon, thus, providing a comprehensive diagnosis and treatment algorithm. Results The most important diagnostic key elements include a detailed clinical medical history, evidence of peanut-specific sensitization by means of skin prick testing and/or in vitro determination of the peanut (extract)-specific IgE and/or the molecular component diagnostics (most important Ara h 2-specific IgE, sometimes also Ara h1-, 3-, 6-, 8- and 9-specific IgE) as well as the gold standard, the double-blind, placebo-controlled food challenge. The diagnostic algorithms were created for the following constellations: Suspected primary peanut allergy with a clear history of systemic immediate-type reaction, suspected primary peanut allergy with questionable symptoms, suspected secondary (possibly pollen-associated) peanut allergy with a history of solely oropharyngeal symptoms and incidental finding of sensitization and no peanut ingestion so far. Conclusions After established diagnosis the standard of care is counseling to avoid peanut contact and prescription of emergency medications (oral antihistamines, oral steroids, inhaled β2-agonists, injectable intramuscular epinephrine) as needed. Instruction on the use of these emergency medications should be provided. A preparation for oral immunotherapy (OIT) for 4 to 17 years old peanut allergic children/ adolescents has been recently approved by the regulatory authorities. OIT for peanut allergy shows high efficacy and an acceptable safety profile, improves quality of life, and health economic aspects. Thus it offers a therapeutic option for peanut allergic children and adolescents.

scholarly journals The effectiveness of oral immunotherapy in patients with Sesame anaphylaxis using Omalizumab

2021 ◽  
Author(s):  
Fereshteh Salari ◽  
Mohammad Hassan Bemanian ◽  
Morteza Fallahpour ◽  
Seyed Alireza Mahdaviani ◽  
Sima Shokri ◽  
...  
Keyword(s):  
Treatment Effectiveness ◽  
Sesame Seed ◽  
Food Challenge ◽  
Maintenance Phase ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Open Label ◽  
Prick Test ◽  
Wheal Diameter ◽  
History Of

Abstract Objective Sesame allergy is the most prevalent allergy to seeds. Oral immunotherapy (OIT) is defined as continuous consumption of an allergen at special doses and time. Omalizumab (Anti-IgE) increases tolerance to allergens used in OIT. This study evaluated the effectiveness of a new sesame OIT protocol in patients with sesame anaphylaxis in combination with omalizumab. Methods In this prospective open-label interventional trial study, 11 patients with a history of sesame anaphylaxis were enrolled after approval by Oral Food Challenge (OFC) test. At baseline, skin prick test (SPT) and skin prick to prick (SPP) test were performed. Serum sesame-specific IgE (sIgE) levels were measured. The maintenance phase was continued at home with daily sesame intake for 4 months. At the end of month 4, the OFC and above-mentioned tests were repeated to evaluate the treatment effectiveness. Results All 11 patients who underwent sesame OIT after 4 months could tolerate a dietary challenge of 22 ml tahini (natural sesame seed, equal to 5,000 mg of sesame protein and higher) and the average of wheal diameter in the SPT and SPP tests significantly decreased after desensitization. Conclusion This OIT protocol may be a promising desensitization strategy for patients with sesame anaphylaxis. Also, omalizumab obviously reduced the severity of reactions.

scholarly journals Anaphylaxis after jellyfish ingestion with no history of stings: a pediatric case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mitsuru Tsuge ◽  
Masanori Ikeda ◽  
Osamu Mitani ◽  
Masato Yasui ◽  
Hirokazu Tsukahara
Keyword(s):  
Immunoglobulin E ◽  
Case Reports ◽  
Challenge Test ◽  
Previous History ◽  
Food Challenge ◽  
Basophil Activation Test ◽  
Skin Reactions ◽  
Prick Test ◽  
Ige Reactivity ◽  
History Of

Abstract Background Jellyfish stings are known to induce allergic skin reactions; however, case reports of anaphylaxis after jellyfish ingestion have been increasing, especially in Asian countries. Some cases of anaphylaxis after jellyfish ingestion have been reported in patients with a previous history of frequent jellyfish stings. Herein, we report a pediatric patient with anaphylaxis after jellyfish ingestion with no history of jellyfish stings. Case presentation A 14-year-old girl developed two episodes of anaphylaxis, and her diet diaries revealed that edible jellyfish was common to the meals in both the anaphylaxis events. A skin prick test using five types of edible jellyfish products revealed a positive reaction to some jellyfish, and anaphylaxis was observed after the ingestion of jellyfish in an oral food challenge test. She had no history of jellyfish stings or frequent swimming in the ocean. The basophil activation test showed positive results on stimulation with extracts from various types of edible jellyfish. We observed serum immunoglobulin E (IgE) reactivity to purified jellyfish collagen and jellyfish acid-soluble extracts. Moreover, immunoblotting analysis showed IgE reactivity to two bands at approximately 40 and 70 kDa using purified jellyfish collagen, which may be a causative antigen. Conclusions Edible salted jellyfish can be one of the causative foods of anaphylaxis. Clinicians should be aware of the possibility of anaphylactic reactions due to jellyfish ingestion even without a history of jellyfish stings.

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