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Published on: May 31, 2021
Natural Course and Prognostic Factors of Immediate-Type Peanut Allergy in Children
Minyoung Jung1, Hye-In Jeong2,3, Yechan Kyung4
1Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Republic of Korea, my.jung@kosin.ac.kr.
Insights
Predicting peanut allergy (PA) resolution in children is crucial. A peanut-specific IgE level of 1 kU/L or higher at diagnosis is linked to persistent PA, with only 10.3% resolving by age six.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Immunology
- Food Allergy Research
Background:
- Predicting food allergy resolution is vital for minimizing dietary restrictions in children.
- Limited data exists on the natural history of peanut allergy (PA) in Korea.
Discussion:
- The study highlights the low spontaneous resolution rate of PA in Korean children by age 10.
- Elevated peanut-specific IgE (sIgE) levels at diagnosis are a significant predictor of persistent PA.
Key Insights:
- Only 14.8% of children in the study experienced PA resolution by age 10.
- A peanut-sIgE level ≥1 kU/L at diagnosis was strongly associated with persistent PA (HR, 5.99).
- The probability of PA resolution was 10.3% by age 6 and 32.8% by age 10.
Outlook:
- Further research is needed to explore interventions for improving PA resolution rates.
- Establishing prognostic markers like peanut-sIgE can aid in personalized management strategies for pediatric PA.
- This study provides essential data on the natural history of PA in a Korean pediatric cohort.
Background:
Predicting food allergy resolution is essential to minimize the number of restricted foods in children. However, there have been no studies on the natural history of peanut allergy (PA) in Korea.
Objective:
This study aimed to evaluate the natural course and prognostic factors of immediate-type PA in children till the age of 10 years.
Methods:
We retrospectively collected data of 122 children who developed PA before 60 months of age from 3 tertiary hospitals in Korea. Diagnosis and resolution of PA was defined as an oral food challenge test or a convincing history of symptoms within 2 h after peanut ingestion. The prognostic factors for resolution of PA were identified using the Cox proportional hazard model.
Results:
The median (interquartile range) age at diagnosis was 2.0 (1.3-3.0) years. Among the 122 children, PA resolved in 18 (14.8%) children. The level of peanut-specific IgE (sIgE) at diagnosis in the persistence group was significantly higher than that in the resolution group (p = 0.026). The probabilities of resolution of PA were 10.3% and 32.8% at the ages of 6 and 10 years, respectively. A peanut-sIgE level ≥1 kU/L at diagnosis was significantly associated with persistent PA (hazard ratio, 5.99; 95% confidence interval, 1.89-18.87).
Conclusions:
Only 10.3% of our patients had a probability of developing spontaneous resolution of PA by 6 years of age. Peanut-sIgE levels ≥1 kU/L at diagnosis were associated with the persistence of PA.
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