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Skin test, RAST and clinical reactions to peanut allergens in children
Insights
Roast peanut allergen extract is the most specific for diagnosing peanut allergy in children. A positive skin or RAST test confirms clinical history, especially in those under four.
Area of Science:
- Food Allergy Research
- Immunology
- Pediatric Allergy
Background:
- Peanut allergy is a common and potentially severe food allergy in children.
- Accurate diagnostic methods are crucial for managing peanut allergy.
- Various allergen preparations exist for skin testing and serological assays.
Purpose of the Study:
- To evaluate the diagnostic efficacy of different peanut allergen preparations in children.
- To determine the most specific skin test extract for peanut allergy.
- To correlate skin test results with clinical symptoms and RAST (Radioallergosorbent Test) findings.
Main Methods:
- 104 children underwent skin prick testing with four peanut allergen preparations: commercial extract, raw peanut extract, roast peanut extract, and a glycoprotein.
- Clinical history of symptoms after peanut ingestion was recorded.
- Results were correlated with RAST testing.
Main Results:
- Roast peanut allergen extract demonstrated the highest specificity, with 8/104 symptomatic children testing positive and only 1 asymptomatic child testing positive.
- Strong correlation observed between raw, roast, and commercial RAST results, indicating shared allergens identified by IgE.
- Clinical sensitivity was higher in younger children, with 75% of positive cases occurring in those under 4 years old.
Conclusions:
- Roast peanut allergen extract is a highly specific tool for diagnosing peanut allergy in children.
- Positive skin prick tests or RAST results corroborate the clinical history of peanut allergy.
- Early diagnosis and confirmation are vital, particularly in young children.
Abstract:
One-hundred-and-four children were skin-tested with four peanut-allergen preparations, a commercial extract, extracts of raw and roast peanuts prepared by NH4HCO3 extraction, and a wheatgerm lectin-reactive glycoprotein obtained by affinity chromatography. The presence of symptoms after ingestion of peanut or peanut products was also recorded. The roast allergen extract provided the greatest specificity with eight symptomatic children having a positive skin test and only one positive skin-test reaction in an asymptomatic child in the group of 104 children tested. Despite differences in the incidence of skin-test reactions there was a strong correlation between raw, roast and commercial RAST suggesting common allergens were being identified by circulating IgE. Clinical sensitivity was observed particularly in younger children with 75% of the children being under 4 years of age. A positive roast skin test or a RAST test adds confirmation to the clinical history of allergic reactions to peanuts.