Early clinical predictors of peanut allergy remission in children

Monday, 19 January 2009 20:55

In efforts to assist in clinical management of peanut allergy, Melbourne-based scientists have published further research into determining the early predictors of peanut allergy remission.

A longitudinal cohort of young children with peanut allergy was established for the study. This consisted of patients less than 2 years of age with peanut allergy 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. Follow-up studies were conducted at 1- to 2-year intervals for up to 8 years and peanut food challenges were performed when SPT responses decreased to less than the 95% positive predictive value for peanut allergy.

Mean SPT wheal diameters of nonremitters increased whereas those of remitters decreased between 1 and 4 years of age. In addition, SPT wheal diameters to peanut extract of 6 mm or greater and peanut-specific IgE antibody of 3 kUA/L or greater before the age of 2 years were independent predictors of persistent peanut allergy.

The authors concluded 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.

Reference: Ho et al. (2008). The Journal of Allergy and Clinical Immunology Vol 121(3), pp. 731-736.