The natural progression of peanut allergy: Resolution and the possibility of recurrence

David M. Fleischer, Mary Kay Conover-Walker, Lynn Christie, A. Wesley Burks, Robert A. Wood

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It was once thought that peanut allergy is a lifelong problem. We previously reported that about 20% of children outgrow their peanut allergy and that more than 60% of patients with a peanut-IgE level of 5 or less passed an oral challenge. Objective: The goal of this study was to further describe the natural progression of peanut allergy by reviewing patients who have undergone oral peanut challenges since the previous study. Methods: Patients with peanut-IgE levels of 5 or less were offered a peanut challenge. Those who passed were further evaluated by questionnaire to assess reintroduction of peanut into their diet and whether any recurrence has occurred. Results: Eighty-four patients were evaluated, and 80 underwent complete analysis. Fifty-five percent with peanut-IgE levels of 5 or less and 63% with peanut-IgE levels of 2 or less passed challenges, compared to 61% and 67%, respectively, in our previous study. The 4 additional patients passed peanut challenges in this study after previously failing. Three patients with initial anaphylactic reactions and 2 patients with initial peanut-IgE levels greater than 70 passed their challenge. Follow-up of those who passed in both studies showed that the majority of patients reintroduced peanut into their diet, but that continued label reading, infrequent/limited ingestion, and aversion to peanut were all common in this population. Two patients had suspected subsequent reactions to peanut after passing their challenge. Conclusions: Patients with a history of peanut allergy and peanut-IgE levels of 5 or less have at least a 50% chance of outgrowing their allergy. Recurrence of peanut allergy may occur but appears to be uncommon.

Original languageEnglish (US)
Pages (from-to)183-189
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume112
Issue number1
DOIs
StatePublished - Jul 1 2003

Keywords

  • Food challenge
  • Food hypersensitivity
  • Peanut allergy
  • RAST
  • Recurrence

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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