The natural history of peanut allergy
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Skolnick, Helen S, et al. The Natural History of Peanut Allergy. 2001. https://doi.org/10.17615/0wkz-dk16APA
Skolnick, H., Conover Walker, M., Barnes Koerner, C., Sampson, H., Burks, A., & Woods, R. (2001). The natural history of peanut allergy. https://doi.org/10.17615/0wkz-dk16Chicago
Skolnick, Helen S., Mary Kay Conover Walker, Celide Barnes Koerner, Hugh A Sampson, A. Wesley Burks, and Robert A Woods. 2001. The Natural History of Peanut Allergy. https://doi.org/10.17615/0wkz-dk16- Creator
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Skolnick, Helen S.
- Other Affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore
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Conover-Walker, Mary Kay
- Other Affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore
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Barnes Koerner, Celide
- Other Affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore
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Sampson, Hugh A.
- Other Affiliation: Department of Pediatrics, Mount Sinai Hospital, New York
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Burks, A. Wesley
- Other Affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock
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Woods, Robert A.
- Other Affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore
- Abstract
- Background: It has traditionally been assumed that peanut allergy is rarely outgrown. Objective: The goal of this study was to determine the number of children with peanut allergy who become tolerant of peanut. Methods: Patients aged 4 to 20 years with a diagnosis of peanut allergy were evaluated by questionnaire, skin testing, and a quantitative antibody fluorescent-enzyme immunoassay. Patients who had been reaction free in the past year and had a peanut IgE (PN-IgE) level less than 20 kilounits of antibody per liter (kUA/L) were offered an open or double-blind, placebo-controlled peanut challenge. Results: A total of 223 patients were evaluated, and of those, 85 (PN-IgE less than 0.35-20.4 kUA/L [median 1.42 kUA/L]) participated in an oral peanut challenge. Forty-eight (21.5%) patients had negative challenge results and were believed to have outgrown their peanut allergy (aged 4-17.5 years [median 6 years]; PN-IgE less than 0.35-20.4 kUA/L [median 0.69 kUA/L]). Thirty-seven failed the challenge (aged 4-13 years [median 6.5 years]; RAST less than 0.35-18.2 kUA/L [median 2.06 kUA/L]). Forty-one patients with PN-IgE levels less than 20 kUA/L declined to undergo challenge, and 97 were not eligible for challenge because their PN-IgE levels were greater than 20 kUA/L or they had had a recent reaction. Sixty-seven percent of patients with PN-IgE levels less than 2 kUA/L and 61% with levels less than 5 kUA/L had negative challenge results. Of those who underwent challenge, PN-IgE levels for those who passed versus those who failed were different at the time of challenge (P = .009), but not at the time of diagnosis (P = .25). Conclusion: This study demonstrates that peanut allergy is outgrown in about 21.5% of patients. Patients with low PN-IgE levels should be offered a peanut challenge in a medical setting to demonstrate whether they can now tolerate peanuts.
- Date of publication
- 2001
- Keyword
- DOI
- Identifier
- 2-s2.0-0035113288
- https://doi.org/10.1067/mai.2001.112129
- Related resource URL
- Resource type
- Article
- Rights statement
- In Copyright
- Journal title
- Journal of Allergy and Clinical Immunology
- Journal volume
- 107
- Journal issue
- 2
- Page start
- 367
- Page end
- 374
- Language
- English
- Version
- Postprint
- ISSN
- 0091-6749
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