Predicting positive food challenges in children sensitised to peanuts/tree nuts.
Pediatr Allergy Immunol
; 24(3): 276-81, 2013 May.
Article
em En
| MEDLINE
| ID: mdl-23551267
ABSTRACT
BACKGROUND:
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.METHODS:
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.RESULTS:
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.CONCLUSIONS:
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.
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Base de dados:
MEDLINE
Assunto principal:
Alérgenos
/
Imunização
/
Hipersensibilidade a Noz
/
Hipersensibilidade a Amendoim
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article