The natural progression of peanut allergy: Resolution and the possibility of recurrence
The natural progression of peanut allergy: Resolution and the possibility of recurrence
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DOI：
10.1067/mai.2003.1517
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发表时间：
2003-07-01
影响因子：
14.2
通讯作者：
Wood, RA
中科院分区：
文献类型：
--
作者：
Fleischer, DM;Conover-Walker, MK;Wood, RA
背景：人们曾经认为花生过敏是一个终身的问题。我们以前报道过，大约20%的儿童在长大后对花生过敏不再敏感，超过60%的花生IgE水平为5或更低的患者通过了口服Challenge.Objective：本研究的目的是通过回顾自上次研究以来接受口服花生挑战的患者，进一步描述花生过敏的自然进展。花生IgE水平为5或更低的患者提供花生挑战。通过问卷调查进一步评估，以评估重新引入花生到他们的饮食，是否有任何复发happened.Results：84例患者进行了评估，80进行了完整的分析。花生IgE水平为5或更低的55%和花生IgE水平为2或更低的63%通过了挑战，而在我们之前的研究中分别为61%和67%。另外4名患者在先前失败后通过了本研究中的花生激发。3例患者的初始过敏反应和2例患者的初始花生IgE水平大于70通过了他们的挑战。对这两项研究中通过的患者的随访显示，大多数患者重新将花生引入他们的饮食中，但继续阅读标签阅读，不频繁/有限的摄入以及对花生的厌恶在这一人群中都很常见。两名患者怀疑随后的反应，花生后，通过他们的challenge.Conclusions：花生过敏史和花生IgE水平为5或更低的患者有至少50%的机会，他们的过敏。花生过敏可能会复发，但似乎并不常见。
Background: It was once thought that peanut allergy is a lifelong problem. We previously reported that about 20% of children outgrow their peanut allergy and that more than 60% of patients with a peanut-IgE level of 5 or less passed an oral challenge.Objective: The goal of this study was to further describe the natural progression of peanut allergy by reviewing patients who have undergone oral peanut challenges since the previous study.Methods: Patients with peanut-IgE levels of 5 or less were offered a peanut challenge. Those who passed were further evaluated by questionnaire to assess reintroduction of peanut into their diet and whether any recurrence has occurred.Results: Eighty-four patients were evaluated, and 80 underwent complete analysis. Fifty-five percent with peanut-IgE levels of 5 or less and 63% with peanut-IgE levels of 2 or less passed challenges, compared to 61% and 67%, respectively, in our previous study. The 4 additional patients passed peanut challenges in this study after previously failing. Three patients with initial anaphylactic reactions and 2 patients with initial peanut-IgE levels greater than 70 passed their challenge. Follow-up of those who passed in both studies showed that the majority of patients reintroduced peanut into their diet, but that continued label reading, infrequent/limited ingestion, and aversion to peanut were all common in this population. Two patients had suspected subsequent reactions to peanut after passing their challenge.Conclusions: Patients with a history of peanut allergy and peanut-IgE levels of 5 or less have at least a 50% chance of outgrowing their allergy. Recurrence of peanut allergy may occur but appears to be uncommon.