The prevalence of outgrowing non-priority legume allergies in children

Non-priority legume (NPL) allergies are increasing, creating significant concerns due to the widespread use of these foods. This study aims to evaluate the natural history of NPL allergy in children and identify predictive factors associated with their resolution.

A retrospective review of medical records of pediatric patients (Age 5-15 Years) from the Pediatric Allergy Department at Evelina London Children's Hospital (from July 2023 to June 2024) who had an IgE-mediated allergy to any NPLs (lentils, chickpeas, peas, and beans). Children with a suggestive history of NPL allergy with a positive skin prick test (SPT) ≥8 Mm, specific immunoglobulin E (sIgE) ≥15 kUA/L and/or positive oral food challenge were included.

Two hundred and three children were included; the median age was 10 years (62.6% male), and median duration of follow-up was 7 years. 6.3% of all children with food allergies were allergic to NPLs, with lentils being most common. Kaplan-Meier analysis showed varying resolution rates by age: 2.2% for lentils, 4.9% for chickpeas, 8.3% for peas, and 13% for beans by age 5. By age 10, these rates increased to 11.3%, 8.8%, 20.1%, and 24.5%, respectively, and by age 15, they increased to 21% for lentils, 19.3% for chickpeas, 23.5% for peas, and 32.9% for beans. Children who had low SPT and sIgE results were more likely to outgrow their legume allergy.

NPL allergy represents a significant disease burden and the rate of resolution by age 15 years was 20%-32.9%, similar to legumes such as peanut.