Predicting positive food challenges in children sensitised to peanuts/tree nuts. Issue 3 (3rd April 2013)

• Record Type: Journal Article
• Authors: Ludman, Sian; Ballabeni, Pierluigi; Eigennman, Philippe A.; Wassenberg, Jacqueline
• Is Part Of: Pediatric allergy and immunology. Volume 24:Issue 3(2013)
• Page Start: 276
• Page End: 281
• Publication Date: 2013-04-03
• Subjects: Allergy in children -- Periodicals; Immunologic diseases in children -- Periodicals; 617
• DOI: 10.1111/pai.12059
• Languages: English
• ISSNs: 0905-6157

Abstract

<abstract abstract-type="main" xml:lang="en" id="pai12059-abs-0001"> <title>Abstract</title> <sec id="pai12059-sec-0001" sec-type="section"> <title>Background</title> <p>Children with atopic diseases in early life are frequently found with positive IgE tests to peanuts/tree nuts without a history of previous ingestion. We aimed to identify risk factors for reactions to nuts at first introduction.</p> </sec> <sec id="pai12059-sec-0002" sec-type="section"> <title>Methods</title> <p>A retrospective case‐note and database analysis was performed. Recruitment criteria were: patients aged 3–16 yr who had a standardized food challenge to peanut and/or tree nuts due to sensitisation to the peanut/tree nut (positive spIgE or SPT) without previous consumption. A detailed assessment was performed of factors relating to food challenge outcome with univariate and multivariate logistic regression analysis.</p> </sec> <sec id="pai12059-sec-0003" sec-type="section"> <title>Results</title> <p>There were 98 food challenges (47 peanut, 51 tree nut) with 29 positive, 67 negative and 2 inconclusive outcomes. A positive maternal history of allergy and a specific IgE >5 kU/l were strongly associated with a significantly increased risk of a positive food challenge (OR 3.73; 95% CI 1.31–10.59; p = 0.013 and OR 3.35; 95% CI 1.23–9.11; p = 0.007, respectively). Adjusting for age, a three year‐old with these criteria has a 67% probability of a positive challenge. There was no significant association between types of peanut/tree nut, other food allergies, atopic conditions or severity of previous food reactions and positive challenges.</p> </sec> <sec id="pai12059-sec-0004" sec-type="section"> <title>Conclusions</title> <p>We have demonstrated an association between the presence of maternal atopic history and a specific IgE >5 kU/l, with a significant increase in the likelihood of a positive food challenge. Although requiring further prospective validation these easily identifiable components should be considered when deciding the need for a challenge.</p> </sec> </abstract>