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Cohort study of peanut and tree nut sensitisation by age of 4 years
S M Tariq1, M Stevens, S Matthews
1Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight.
Insights
Peanut allergy affects 1.2% of children, with many cases persisting into childhood. However, some children may develop tolerance to peanuts over time.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology of Food Allergies
- Immunology of Sensitization
Background:
- Food allergies, particularly to peanuts and tree nuts, are a growing public health concern.
- Understanding the prevalence and natural history of these allergies in early childhood is crucial for effective management and prevention strategies.
Purpose of the Study:
- To determine the prevalence of sensitization to peanuts and tree nuts in a birth cohort.
- To identify risk factors associated with the development of peanut allergy.
- To investigate the persistence and potential development of tolerance to peanut allergy.
Main Methods:
- A prospective birth cohort study was conducted on the Isle of Wight.
- Children were reviewed at ages 1, 2, and 4 years, with skin prick tests performed at age 4.
- Data collected included sensitization status, clinical atopic disease, and family history.
Main Results:
- 1.2% of children (15/1218) were sensitized to peanuts or tree nuts, with 13 sensitized to peanuts.
- 0.5% of the population experienced allergic reactions to peanuts, with a few cases of anaphylaxis.
- Family history of atopy, egg allergy, and eczema were significant predictors of peanut allergy.
Conclusions:
- IgE-mediated peanut allergy is prevalent in early childhood.
- While many children with peanut allergy experience persistent symptoms, a subset may develop tolerance.
- Early identification of risk factors can aid in predicting and potentially preventing severe allergic reactions.
Objective:
To determine the prevalence of sensitisation to peanuts and tree nuts in all children born during one year in one geographical area.
Design:
Birth cohort study with structured review at ages 1, 2, and 4 years.
Setting:
All children born on the Isle of Wight between January 1989 and February 1990.
Subjects:
Of 1456 children originally included, 1218 were reviewed at age 4 years. Of these, 1981 had skin prick tests.
Main Outcome Measures:
Positive skin test results, clinical atopic disease, and risk factors for the development of atopy.
Results:
15 of 1218 (1.2%) children were sensitised to peanuts or tree nuts (13 to peanuts). Six had had allergic reactions to peanuts (0.5% of the population), one to hazelnuts, and one to cashew nuts; three had had anaphylactic reactions. Seven children had positive skin test results or detectable IgE to peanuts without clinical symptoms. Two children who reacted to peanut in infancy had lost their sensitivity by 4 years. Family history of atopy, allergy to egg (odds ratio 9.9, 95% confidence interval 2.1 to 47.9, and eczema (7.3, 2.1 to 26.1) were important predictors for peanut allergy.
Conclusions:
IgE mediated allergy to peanuts is common in early childhood. In many the allergy persists but a minority may develop tolerance.