Defining challenge-proven coexistent nut and sesame seed allergy: A prospective multicenter European study
| Autor: | Suzana Radulovic, Diab Haddad, Helen A. Brough, Gideon Lack, Marcel Bergmann, Philippe Eigenmann, Antonio Nieto, María Nieto, Jacqueline Wassenberg, Valentina Panetta, Angel Mazon, Jean-Christoph Roger J-P Caubet, Rosalynd Gourgey, Alexandra F. Santos |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Nut Allergy Peanut allergy Adolescent Immunology Sesamum Toxicology Age London Prevalence Humans Nuts Immunology and Allergy Medicine Prospective Studies Child Tree nut allergy ddc:618 business.industry Oral food challenge Incidence digestive oral and skin physiology Infant Newborn Sesame seed allergy Infant food and beverages Atopic dermatitis Odds ratio Geneva Allergens medicine.disease Sesame seed Europe Multiple nut allergies Child Preschool Seeds Female Immunization Valencia business Food Hypersensitivity Predictor |
| Zdroj: | Journal of Allergy and Clinical Immunology, Vol. 145, No 4 (2020) pp. 1231-1239 |
| ISSN: | 0091-6749 |
| DOI: | 10.1016/j.jaci.2019.09.036 |
| Popis: | Background Peanut, tree nut, and sesame allergies are responsible for most life-threatening food-induced allergic reactions. Rates of coexistent allergy between these foods have been from mostly retrospective studies that include only a limited number of tree nuts or were not based on oral food challenges. Objective The Pronuts study is a multicenter European study (London, Geneva, and Valencia) assessing the challenge-proven rate of coexistent peanut, tree nut, and/or sesame seed allergy. Methods Children aged 0 to 16 years with at least 1 confirmed nut or sesame seed allergy underwent sequential diagnostic food challenges to all other nuts and sesame seed. Results Overall, the rate of coexistent peanut, tree nut, and sesame seed allergy was 60.7% (n = 74/122; 95% CI, 51.4% to 69.4%). Peanut allergy was more common in London, cashew and pistachio nut allergies were more common in Geneva, and walnut and pecan allergies were more common in Valencia. Strong correlations were found between cashew-pistachio, walnut-pecan, and walnut-pecan-hazelnut-macadamia clusters. Age (>36 months) and center (Valencia > Geneva > London) were associated with an increased odds of multiple nut allergies. By pursuing the diagnostic protocol to demonstrate tolerance to other nuts, participants were able to introduce a median of 9 nuts. Conclusion We found a higher rate of coexistent nut and sesame seed allergies than previously reported. Performing sequential food challenges was labor intensive and could result in severe allergic reactions; however, it reduced dietary restrictions. Age was a significant predictor of multiple nut allergies, and thus the secondary spread of nut allergies occurred in older children. |
| Databáze: | OpenAIRE |
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