Recurrent peanut allergy may not be prevented by continued peanut ingestion

Recurrent peanut allergy has been described in patients who have previously passed an oral food challenge [N Engl J Med 2002;347:1535-1536]. It has been suggested that recurrent peanut allergy might be prevented by regular ingestion of peanut subsequent to passing an oral food challenge [J Allergy Clin Immunol 2004;114:1195-1201]. We present a case that challenges this thinking by demonstrating that peanut allergy may recur during regular ingestion of significant doses of peanut protein. The case suggests that current practice cannot guarantee freedom from recurrent peanut allergy, and it is important that patients and their families are aware of this.