Fixed food eruption caused by peanut confirmed by open oral food challenge and in vitro cellular testing (original) (raw)
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Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2018
Peanut allergy is classically managed by food avoidance. Immunotherapy programmes are available at some academic centers for selected patients reacting to small amounts of peanut during food challenge. We aimed to determine and compare reaction thresholds and prevalence of anaphylaxis during peanut oral challenges at multiple specialist allergy centers. A retrospective, international survey of anonymized case records from seven specialist paediatric allergy centers from the UK and Ireland, as well as the Australian HealthNuts study. Demographic information, allergy test results, reaction severity and threshold during open oral peanut challenges were collated and analysed. Of the 1,634 children aged 1 to 18 years old included, 525 (32%) failed their peanut challenge. 28% reacted to 25mg, while 38% only reacted after consuming 1g or more of whole peanut. Anaphylaxis (55 (11%)) was 3-times more common in teenagers than younger children and the likelihood increased at all ages as childr...
Paediatric oral peanut challenges: a comparison of practice in London and Western Switzerland
Allergy, 2013
Background: There are guidelines on how to develop a food challenge protocol, but at present there is no gold standard guidance on method, and separate units produce differing protocols. Methods: We performed a retrospective analysis of 200 patients' data from the paediatric allergy units in Lausanne and Geneva, Western Switzerland, and St Thomas' Hospital (STH), UK. Results: St Thomas' Hospital has a younger cohort with a lower overall mean spIgE (2.36 kU/l vs 8.00 kU/l, P = 0.004). The target peanut protein volumes differed: Switzerland 4.4 g vs STH 8.4 g. Despite this, the dose actually achieved in positive challenges was not significantly different (2.33 g vs 1.49 g, P = 0.16). 26% of challenges reacted at 4 g or more of peanut protein. Conclusions: The differences in results highlight how the variation in reasoning behind food challenge alters the outcome. Standardization of food challenges would allow easy comparison between hospitals and geographical areas for research purposes.
Journal of AOAC INTERNATIONAL, 2021
Background Regulations in many countries worldwide prescribe that peanut must be listed on food labels as a cause of food allergies. Re-evaluated VITAL values for peanut revealed ED01 value—at which 99% of all peanut-allergic individuals will not react—is 0.2 mg of peanut protein. Objective Validation of a sandwich ELISA based on monoclonal antibodies to detect peanut proteins. Methods Non-processed and processed samples are extracted by an easy procedure at 60 °C within 10 min. The measurement range is between 0.75 mg/kg peanut and 6 mg/kg peanut using a NIST reference material as calibrator. Results The system shows no cross-reactivity against 91 different food commodities. LoD was found at 0.15 mg/kg for food matrices such as cookies, milk chocolate, ice cream, trail mix, puffed rice cereal, and granola bar. LoQ was verified at a level of 0.75 mg/kg. Recovery studies with incurred milk chocolate and -ice cream revealed consistent recoveries between 67% and 85%. Mean recoveries fo...
Processing Can Alter the Properties of Peanut Extract Preparations
Journal of Agricultural and Food Chemistry, 2010
As peanut allergy is an increasing public health risk, affecting over 1% of the United States and United Kingdom school children, it is important that methods and reagents for accurate diagnosis of food allergy and detection of allergenic foods are reliable and consistent. Given that most current experimental, diagnostic, and detection tests rely on the presence of soluble allergens in food extracts, we investigated the effects of thermal processing on the solubility and IgE binding of the major peanut allergens, Ara h 1 and Ara h 2. The soluble and insoluble fractions of peanuts that were boiled, fried, and roasted were subjected to electrophoresis and Western blot analysis using anti-Ara h 1 and anti-Ara h 2 antibodies and serum IgE from peanut allergic individuals. Overall protein solubility is reduced with processing and IgE binding increases in the insoluble fractions, due mostly to the increase in the amount of insoluble proteins, with increased time of heating in all processes tested. Therefore, it can be concluded that thermal processing of peanuts alters solubility, and the differences in protein solubility within various extract preparations may contribute to inconsistent skin prick test and immunoassay results, particularly when nonstandardized reagents are used.
Peanut allergy: An increasingly common life-threatening disorder
Journal of the American Academy of Dermatology, 2012
Allergic reactions to peanuts in children have become a significant medical and legal concern worldwide, with a rising incidence of this potentially fatal condition. Peanut allergy represents an immunoglobulin E (IgE)emediated hypersensitivity reaction to peanut proteins and is responsible for the majority of cases of food-induced anaphylaxis. Even trace quantities of peanut in a sensitized individual can be fatal, with rapid onset of symptoms often including the cutaneous findings of urticaria, angioedema, or a diffuse nonspecific dermatitis. Peanut allergy is usually a lifelong condition, since only about 20% of affected individuals outgrow it. Some schools ban peanut butter and jelly sandwiches, once a common dietary option, as fear of medical and legal consequences is escalating. Children with peanut allergy and their families should be knowledgeable about management strategies, including carrying and properly administering self-injectable epinephrine. New immunotherapeutic options are being investigated and appear promising.
Comprehensive Reviews in Food Science and Food Safety, 2007
Attention to peanut allergy has been rising rapidly for the last 5 y, because it accounts for the majority of severe food-related anaphylaxis, it tends to appear early in life, and it usually is not resolved. Low milligram amounts of peanut allergens can induce severe allergic reactions in highly sensitized individuals, and no cure is available for peanut allergy. This review presents updated information on peanut allergy, peanut allergens (Ara h1 to h8), and available methods for detecting peanuts in foods. These methods are based on the detection of either peanut proteins or a specific DNA fragment of peanut allergens. A summary of published methods for detecting peanut in foods is given with a comparison of assay formats, target analyte, and assay sensitivity. Moreover, a summary of the current availability of commercial peanut allergen kits is presented with information about assay format, target analyte, sensitivity, testing time, company/kit name, and AOAC validation.
Peanuts in Encyclopedia of Food and Health
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