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

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: I...

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Detalles Bibliográficos
Autores principales: Wainstein, Brynn Kevin, Saad, Rebecca Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521166/
https://www.ncbi.nlm.nih.gov/pubmed/26240794
http://dx.doi.org/10.5415/apallergy.2015.5.3.170
Descripción
Sumario: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.