- Title
- Early clinical predictors of remission of peanut allergy in children
- Creator
- Ho, Marco H. K.; Wong, Wilfred H. S.; Heine, Ralf G.; Hosking, Clifford S.; Hill, David J.; Allen, Katrina J.
- Relation
- Journal of Allergy and Clinical Immunology Vol. 121, Issue 3, p. 731-736
- Publisher Link
- http://dx.doi.org/10.1016/j.jaci.2007.11.024
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2008
- Description
- Background: Understanding predictors of clinical remission would assist in clinical management of peanut allergy. Objective: We sought to determine the early clinical predictors of peanut allergy remission using a longitudinal cohort of young children with peanut allergy. Methods: Consecutive patients less than 2 years of age with peanut allergy were identified on the basis of skin prick test (SPT) wheal size of 95% positive predictive value or greater. Baseline SPT responses to peanuts, tree nuts, and sesame and serum peanut-specific IgE antibody levels were documented, and follow-up studies were conducted at 1- to 2-year intervals for up to 8 years. Peanut food challenges were performed when SPT responses decreased to less than the 95% positive predictive value for peanut allergy. Results: SPT wheal diameters to peanut extract of 6 mm or greater (hazard ratio, 2.16; 95% CI, 1.23-3.786; P = .008) and peanut-specific IgE antibody of 3 kUA/L or greater (hazard ratio, 2.74; 95% CI, 1.13-6.61; P = .025) before the age of 2 years were independent predictors of persistent peanut allergy. Mean SPT wheal diameters of nonremitters increased (r 5 0.31, P < .001), whereas those of remitters decreased (r = 20.26, P = .002) between 1 and 4 years of age. Twenty-one percent of young children with peanut allergy became clinically tolerant by age 5 years. Conclusions: Remission of peanut allergy can be predicted by low levels of IgE antibodies to peanut in the first 2 years of life or decreasing levels of IgE sensitization by the age of 3 years.
- Subject
- peanut allergy; tree nut; sesame; clinical predictors; skin prick test; peanut-specific IgE
- Identifier
- uon:5372
- Identifier
- http://hdl.handle.net/1959.13/43251
- Identifier
- ISSN:0091-6749
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