Peanut avoidance and peanut allergy diagnosis in siblings of peanut allergic children
Peanut avoidance and peanut allergy diagnosis in siblings of peanut allergic children
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DOI：
10.1111/cea.12403
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发表时间：
2015-01-01
影响因子：
6.1
通讯作者：
Ben-Shoshan, M.
中科院分区：
文献类型：
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作者：
Lavine, E.;Clarke, A.;Ben-Shoshan, M.
背景研究表明，患有花生过敏 (PNA) 的儿童的兄弟姐妹的 PNA 患病率高于一般人群。 目的 加拿大花生过敏登记处用于评估注册指数 PNA 儿童的兄弟姐妹中 1) 从未接触过花生或 2) 据报道被医生诊断为 PNA 且没有过敏反应史或确认检测的百分比。对可能与任一结果相关的社会人口学和临床因素进行了评估。方法父母填写了一份关于兄弟姐妹的社会人口学特征、对花生的接触和反应、进行的验证性测试以及是否已诊断出 PNA 的调查问卷。结果在 932 个登记家庭中，748 个家庭进行了答复，代表 922 个兄弟姐妹。 13.6% 的兄弟姐妹从未接触过花生，其中 70.4% (n=88) 是在索引孩子之后出生的。近 9% 的兄弟姐妹 (80) 被报告患有 PNA，但该组中近一半的人没有对花生过敏反应史，其中包括 5 名儿童，他们也没有接受过确认 PNA 的测试。在这 5 名儿童中，有 4 名是在 PNA 诊断后出生的指标儿童。在对至少 3 岁的兄弟姐妹进行的多变量回归分析中，那些在 PNA 诊断后出生的指标孩子更有可能从未接触过花生。在单变量分析中，指标儿童诊断为 PNA 后出生的兄弟姐妹更有可能在没有支持性病史或验证性检测的情况下被诊断为 PNA。结论和临床相关性这些数据估计，超过 10% 的 PNA 患者的兄弟姐妹会避免吃花生，而指标儿童诊断为 PNA 后出生的兄弟姐妹更有可能从未接触过花生。需要制定教育计划和指南来警告人们避免不必要的回避。
BackgroundStudies suggest that siblings of children with peanut allergy (PNA) have a higher prevalence of PNA than the general population.ObjectivesThe Canadian Peanut Allergy Registry was used to assess the percentage of siblings of registered index PNA children who were 1) never exposed to peanut or 2) reportedly diagnosed with PNA by a physician without either a history of allergic reaction or a confirmatory testing. Sociodemographic and clinical factors that may be associated with either outcome were evaluated.MethodsParents completed a questionnaire on siblings' sociodemographic characteristics, exposure and reaction to peanut, confirmatory tests performed and whether PNA had been diagnosed.ResultsOf 932 Registry families, 748 families responded, representing 922 siblings. 13.6% of siblings had never been exposed to peanut, 70.4% (n=88) of which were born after the index child. Almost 9% of siblings (80) were reported as PNA, but almost half of this group had no history of an allergic reaction to peanut, including five children who also had no testing to confirm PNA. Of these 5, 4 were born after PNA diagnosis in the index child. In a multivariate regression analysis for siblings at least 3years old, those born after PNA diagnosis in the index child were more likely to have never been exposed to peanut. In a univariate analysis, siblings born after the diagnosis of PNA in the index child were more likely to be diagnosed with PNA without supportive history or confirmatory testing.Conclusions and Clinical RelevanceThese data estimate that more than 10% of siblings of PNA patients will avoid peanut and that siblings born after the diagnosis of PNA in an index child are more likely to have never been exposed. Educational programs and guidelines that caution against unnecessary avoidance are required.