Food, drug, insect sting allergy, and anaphylaxisEarly clinical predictors of remission of peanut allergy in children
Section snippets
Methods
Consecutive children less than 2 years of age referred to the Children's Allergy Centre, Royal Children's Hospital, Melbourne, from 1995 through 2000 and found to have peanut allergy were studied. Peanut allergy was diagnosed if the child had a skin prick test (SPT) diameter of 95% positive predictive value (PPV) or greater for peanut allergy (ie, an SPT response to peanut ≥4 mm).14 Approval for this study was granted by the Royal Children's Hospital Institutional Review Board.
Results
A total of 297 children were given diagnoses of peanut allergy (mean/median age, 14.1/13.5 months; range, 4-23 months; male/female ratio, 1.9:1) during the study period. Of these, 267 who had come back for subsequent evaluation formed this study population, with a median follow-up of 4.7 years (SD, 2 years). They presented (1) with a history of an adverse reaction to peanut (93 [35%] patients), (2) for investigation of an adverse reaction to other common food allergens (109 [41%] patients), or
Discussion
Both the size of the SPT wheal to peanut and the level of serum peanut-specific IgE before 2 years of age were independent predictors of clinical remission to peanut. However, age at diagnosis, mode of presentation, and severity of index reaction were not predictive of remission. SPT response to peanut extract of 6 mm or larger or peanut-specific IgE levels of greater than 3 KUA/L before 2 years of age halved the probability of tolerance development. The long-term prognosis for peanut allergy
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Dr Ho was supported by the Ho Hung Chiu Medical Education Scholarship and training grant of the Hospital Authority, Hong Kong SAR, China. Dr Allen is a recipient of an Australian National Health and Medical Research Council Career Development Award and has funding from the Ilhan Food Allergy Foundation and AnaphylaxiStop.
Disclosure of potential conflict of interest: The authors have declared that they have no relevant conflict of interest.