Pearls and pitfalls of implementing LEAP strategy for peanut: A case report
Evelyn A Wang1, Bruce J Lanser1, Nathan Rabinovitch1
1From the Department of Pediatrics, National Jewish Health, Denver, Colorado.
Insights
Early peanut introduction is common for high-risk infants. However, some infants develop peanut allergy even after supervised consumption, as shown in this rare case of anaphylaxis despite a negative skin test.
Area of Science:
- Allergy and Immunology
- Pediatric Medicine
- Clinical Research
Background:
- Early peanut introduction is recommended for infants at high risk of peanut allergy.
- Despite guidelines, a small percentage of infants develop peanut allergy even with regular consumption.
- Existing literature on severe reactions post-introduction is limited.
Purpose of the Study:
- To report a rare case of anaphylaxis to peanut in a 6-month-old infant.
- To highlight the occurrence of severe allergic reactions despite negative diagnostic tests and supervised introduction.
- To contribute to the understanding of potential risks associated with early peanut consumption.
Main Methods:
- Case report of a 6-month-old infant experiencing anaphylaxis.
- Review of the infant's history including skin-prick testing and supervised peanut introduction.
- Analysis of the clinical presentation and outcome.
Main Results:
- The infant experienced anaphylaxis despite a negative peanut skin-prick test.
- The reaction occurred after a period of successful supervised introduction and home consumption.
- This presentation is exceptionally rare, with only one similar case previously documented.
Conclusions:
- Anaphylaxis to peanut can occur in high-risk infants even after negative skin-prick tests and successful introduction.
- Clinical vigilance is crucial, as diagnostic tests may not always predict severe reactions.
- Further research is needed to understand the mechanisms behind such rare allergic responses.
Abstract:
Early introduction of peanut in infants at high risk has been widely adopted and implemented in pediatric outpatient clinics since 2017. It is often overlooked that almost 2% of infants went on to develop peanut allergy despite regular consumption in a previous study. Here we described a case of anaphylaxis to peanut in a 6-month-old infant after a negative skin-prick test result, supervised introduction in the clinic, and successful home consumption, which, to our knowledge, has only previously been described once in the literature.
