Predicting positive food challenges at the introduction of nuts in sensitised children

TitrePredicting positive food challenges at the introduction of nuts in sensitised children
Publication TypeConference Paper
Year of Publication2012
AuthorsLudman, SW, Ballabeni, P, Hofer, M, Eigenmann, PA, Wassenberg, J
Conference NameAAAAI 2012, Annual Meeting of the American Academy of Allergy, Asthma and Immunology
Conference LocationOrlando, United-States, March 2-6, 2012
ISBN Number0091-6749
Accession Numberserval:BIB_43E1C6CB8EBF

Rationale: Children with atopic diseases in early life are frequently found with positive IgE tests to nuts, without a history of previous ingestion. We aimed to identify risk factors for reactions to nuts at their first introduction.
Methods: A detailed retrospective case note and database analysis was performed. Inclusion criteria were: patients aged 3 to 16 years who had had a standardized food challenge to peanut and/or tree nuts due to primary sensitisation to the nut (positive specific IgE or SPT). 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 (48% peanut, 52% tree nut) with 29 positive, 67 negative and 2 inconclusive challenges. A positive maternal history and a specific IgE > 2 kU/l were strongly associated with a significantly increased risk of a positive food challenge (OR 3.54; 95% CI 1.28 to 9.81; and OR 4.82; 95% CI 1.57 to 14.86; respectively). There was no significant association between the type of nut, age, presence of other food allergies, paternal or sibling atopic history, other atopic conditions or severity of previous reaction to other foods.
Conclusions: We have demonstrated an association between the presence of a maternal atopic history and a specific IgE > 2 kU/l, and a significant increase in the likelihood of a positive food challenge in children with primary sensitisation to nuts. Although requiring further prospective validation we suggest these easily identifiable components should be considered when deciding the need for a nut challenge.


Citation Key / SERVAL ID5093


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