Resolution of peanut allergy: case-control study
Resolution of peanut allergy: case-control study
复制标题
DOI：
10.1136/bmj.316.7140.1271
复制
发表时间：
1998-04-25
影响因子：
--
通讯作者：
Warner, JO
中科院分区：
文献类型：
--
作者：
Hourihane, JO;Roberts, SA;Warner, JO
目的：为了确定对花生保持轻度或中度过敏的儿童与有类似病史但对花生挑战有阴性反应的儿童之间是否有任何差异设计：年龄和性别匹配的病例对照。设置：两所教学医院的儿童日间病房。干预：花生开放食物挑战。受试者：15名儿童花生过敏症状缓解（消退者）和15例持续性过敏主要结果测量：对花生攻击的反应，血清总IgE和花生特异性IgE浓度。这些组对花生的第一反应的中位年龄相似（11个月，范围5-38），症状相似。对其他食物过敏在消退者（2/15）中比持续者（9/15）少（P = 0.02）。在用花生进行的皮肤点刺试验中，所有13个消退者都进行了测试，但只有3/14的持续者具有< 6 mm CP < 0.0001的伤痕。总的和花生特异性IgE浓度并没有太大的不同groups.Conclusion：适当培训的临床医生必须准备挑战学龄前儿童与花生，因为有些人会容忍，尽管历史上的反应花生和积极的皮肤点刺试验与花生学龄前儿童的明显的花生过敏是驳斥食物挑战显示过敏的其他食物往往比那些花生过敏持续存在。对花生的皮肤点刺试验上的伤痕的大小可预测对花生攻击的反应性，但不能预测严重性。
Objectives: To determine whether there are any differences between children who remain mildly or moderately allergic to peanut and children with similar histories but a negative reaction on challenge with peanutDesign: Case-controls matched for age and sex.Setting: Children's day wards in two teaching hospitals.Intervention: Open food challenge with peanut.Subjects: 15 children with resolved peanut allergy (resolvers) and 15 with persistent allergy (persisters).Main outcome measure: Reaction on challenge with peanut, serum total and peanut specific IgE concentrations.Results: The groups had a similar median age at first reaction to peanut (11 months, range 5-38) and similar symptoms. Allergy to other foods was less common in resolvers (2/15) than persisters (9/15) (P = 0.02). On skin prick testing with peanut all 13 resolvers tested but only 3/14 persisters had a weal of < 6 mm CP < 0.0001). Total and peanut specific IgE concentrations did not differ much between the groups.Conclusion: Appropriately trained clinicians must be prepared to challenge preschool children with peanut as some will be tolerant despite a history of reactions to peanut and a positive skin prick test with peanut Preschool children whose apparent peanut allergy is refuted by food challenge show allergy to other foods less often than those in whom peanut allergy persists. The size of weal on skin prick testing to peanut predicts reactivity but not severity on peanut challenge.