Predicting positive food challenges in children sensitised to peanuts/tree nuts.

TitrePredicting positive food challenges in children sensitised to peanuts/tree nuts.
Publication TypeJournal Article
Year of Publication2013
AuthorsLudman, S, Ballabeni, P, Eigenmann, PA, Eigennman, PA, Wassenberg, J
JournalPediatr Allergy Immunol
Date Published2013 May
Mots-clésAdolescent, Allergens, Arachis hypogaea, Child, Child, Preschool, Female, Humans, Immunization, Immunoglobulin E, Male, Nut Hypersensitivity, Peanut Hypersensitivity, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Adjustment

BACKGROUND: Children with atopic diseases in early life are frequently found with positive IgE tests to peanuts/tree nuts without a history of previous ingestion. We aimed to identify risk factors for reactions to nuts at first introduction.

METHODS: A retrospective case-note and database analysis was performed. Recruitment criteria were: patients aged 3-16 yr who had a standardized food challenge to peanut and/or tree nuts due to sensitisation to the peanut/tree nut (positive spIgE or SPT) without previous consumption. A detailed assessment was performed of factors relating to food challenge outcome with univariate and multivariate logistic regression analysis.

RESULTS: There were 98 food challenges (47 peanut, 51 tree nut) with 29 positive, 67 negative and 2 inconclusive outcomes. A positive maternal history of allergy and a specific IgE >5 kU/l were strongly associated with a significantly increased risk of a positive food challenge (OR 3.73; 95% CI 1.31-10.59; p = 0.013 and OR 3.35; 95% CI 1.23-9.11; p = 0.007, respectively). Adjusting for age, a three year-old with these criteria has a 67% probability of a positive challenge. There was no significant association between types of peanut/tree nut, other food allergies, atopic conditions or severity of previous food reactions and positive challenges.

CONCLUSIONS: We have demonstrated an association between the presence of maternal atopic history and a specific IgE >5 kU/l, with a significant increase in the likelihood of a positive food challenge. Although requiring further prospective validation these easily identifiable components should be considered when deciding the need for a challenge.

Alternate URL

Alternate JournalPediatr Allergy Immunol
Citation Key / SERVAL ID3410
PubMed ID23551267


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