Aspects pratiques de l'allergie à l'arachide: du diagnostic à la prévention
ABSTRACT The prevalence of food allergy to peanuts has doubled over the last ten years. The prevalence of this allergy in the general population is 1.3 % in England and 0.4 % in the United States. In France, the prevalence of peanut allergy is unknown, however its frequency is clearly increasing. Peanut allergy is the commonest food allergy in children over the age of 3 years. Although the most frequent clinical presentation is atopic dermatitis, the symptoms are more severe than for other food allergies. The diagnosis must be based on standardized tests. The oral challenge test defines the reactogenic dose and the risk involved and represents the reference examination. Practical difficulties of diet and the severity of clinical manifestations may constitute an indication for specific immunotherapy, whose modalities have yet to be defined. Primary prévention is based on exclusion of peanuts during pregnancy and breastfeeding in families with a high risk of allergy.
Article: Peanut anaphylaxis.Journal of Allergy and Clinical Immunology 08/1990; 86(1):1-3. · 12.05 Impact Factor
- Clinical & Experimental Allergy 12/1997; 27(11):1240-6. · 4.79 Impact Factor
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ABSTRACT: The current increase in the prevalence of food allergies appears to have several causes including better screening, improved diagnosis and changes in both the techniques used by food manufacturers and eating habits. Labial food challenge (LFC)is simple, rapid to perform and is associated with only low risks of systemic reaction. It is thus an appealing alternative to the oral food challenge (OFC) for pediatric use. We report a series of 202 LFC performed over two years in 142 children with food allergy suspected from the case history, positive skin prick tests and specific serum IgE assays: 156 LFC were positive; and 46 negative, followed by positive single-blind, placebo-controlled food challenges (SBPCFC). The foods provoking reactions were egg white (75 cases), peanut (60 cases), mustard (23 cases), cow's milk (13 cases), cod (8 cases), kiwi fruit, shrimp (4 cases each), chicken, peanut oil (3 cases each), hazel nuts (2 cases), and snails, apple, fennel, garlic, chilli peppers, pepper, and duck (1 case each). LFC positivity was mostly (89.7% of cases) manifested as a labial edema with contiguous urticaria. There were systemic reactions in 4.5% of cases: generalized urticaria, hoarseness and rapid-onset and generalized eczema. The 46 infants with negative LFC results had positive SBPCFC. The reactions were in 34 cases generalized urticaria, 10 cases asthma attacks, 2 cases early and generalized eczema, and in one case general anaphylactic shock. The sensitivity of the LFC was 77%. The LFC was easy to perform with children. Positive results indicate the presence of food allergy, but negative results require further investigations preferably double-blind, placebo-controlled food challenge (DBPCFC).Pediatric Allergy and Immunology 03/1997; 8(1):41-4. · 3.38 Impact Factor