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.
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ABSTRACT: We report our findings on a group of 69 children without cow’s milk allergy who had one or several other food allergies between 6 and 18 months of age. Their initial symptoms were of moderate to severe intensity: 61 (88.5%) of them had had systemic symptoms, including angioedema (52%), generalized urticaria (36%), laryngeal edema (13%) and asthma (10%). In 11.5% of the patients, the first sign was severe acute eczema that did not respond to the usual treatment. The most important allergens, those identified with skin tests, serological assay for specific IgE antibody and labial or oral challenge tests, were egg (60.2%), peanut (50%), fish (10.3%) and cashew nut (5.8%). An atopic background was present in 90% of these infants. Of those allergic to eggs, 53% subsequently had no reaction to this food, whereas only one child allergic to peanuts and none of those allergic to cashew nuts or fish became symptom-free. Forty-three percent of the infants suffered from multiple food allergies, and asthma had developed in 33 (48%) of them. In conclusion, the early onset of food allergy and the presence of multiple sensitivities in this group of patients pointed to the seriousness and the unfavorable evolution of their allergic condition.Revue Française d Allergologie et d Immunologie Clinique 06/2004; 44(4):382-388. · 0.24 Impact Factor