White paper peanut allergy—part 2: Diagnosis of peanut allergy with special emphasis on molecular component diagnostics

被引：0

作者：

Blum L.A. ^{[1
]}

Ahrens B. ^{[1
,2
]}

Klimek L. ^{[3
]}

Beyer K. ^{[4
]}

Gerstlauer M. ^{[5
]}

Hamelmann E. ^{[6
]}

Lange L. ^{[7
]}

Nemat K. ^{[8
]}

Vogelberg C. ^{[9
]}

Blumchen K. ^{[1
]}

机构：

[1] Department of Pediatric and Adolescent Medicine, Allergology, Pneumology, Cystic Fibrosis, University Hospital, Johann-Wolfgang-Goethe University, Frankfurt

[2] Department of Allergology, Paul-Ehrlich-Institut, Langen

[3] Center for Rhinology and Allergology Wiesbaden, Wiesbaden

[4] Department of Pediatric Respiratory Medicine, Immunology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin

[5] Department for Pediatric Pneumology and Allergology, Clinic for children and adolescents, University Hospital Augsburg, Augsburg

[6] Pediatric and Adolescent Medicine, Bethel Children’s Center, OWL University Hospital of Bielefeld University, Bielefeld

[7] Department of Pediatrics, St. Marien Hospital, GFO Clinics Bonn, Bonn

[8] Practice for Pediatric Pneumology/Allergology, Kinderzentrum Dresden (Kid), Dresden

[9] Clinic and Polyclinic for Pediatrics and Adolescent Medicine, Department of Pediatric Pneumology/Allergology, University Hospital Carl Gustav Carus, TU Dresden, Dresden

来源：

Allergo Journal International | 2021年 / 30卷 / 8期

关键词：

Ara h 2‑specific IgE; Diagnostic algorithm; Oral food challenge; Peanut skin prick test; Peanut-specific IgE;

D O I：

10.1007/s40629-021-00190-6

中图分类号：

学科分类号：

摘要：

Background: Peanut allergy is an immunoglobulin E (IgE)-mediated immune response that usually manifests in childhood and can range from mild skin reactions to anaphylaxis. Since quality of life maybe greatly reduced by the diagnosis of peanut allergy, an accurate diagnosis should always be made. Methods: A selective literature search was performed in PubMed and consensus diagnostic algorithms are presented. Results: Important diagnostic elements include a detailed clinical history, detection of peanut-specific sensitization by skin prick testing and/or in vitro measurement of peanut (extract)-specific IgE and/or molecular components, and double-blind, placebo-controlled food challenge as the gold standard. Using these tools, including published cut-off values, diagnostic algorithms were established for the following constellations: 1) Suspicion of primary peanut allergy with a history of immediate systemic reaction, 2) Suspicion of primary peanut allergy with questionable symptoms, 3) Incidental findings on sensitization testing and peanut ingestion so far or 4) Suspicion of pollen-associated peanut allergy with solely oropharyngeal symptoms. Conclusion: The most important diagnostic measures in determining the diagnosis of peanut allergy are clinical history and detection of sensitizations, also via component-based diagnostics. However, in case of unclear results, the gold standard—an oral food challenge—should always be used. © 2021, The Author(s).

引用

页码：270 / 281

页数：11

共 63 条

[1]

DunnGalvin A., Blumchen K., Timmermans F., Regent L., Schnadt S., Podesta M., Et al., APPEAL-1: a multiple-country European survey assessing the psychosocial impact of peanut allergy, Allergy, 75, pp. 2899-2908, (2020)

[2]

DunnGalvin A., Gallop K., Acaster S., Timmermans F., Regent L., Schnadt S., Et al., APPEAL-2: a pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers, Clin Exp Allergy, 50, pp. 1238-1248, (2020)

[3]

Worm M., Jappe U., Kleine-Tebbe J., Schafer C., Reese I., Saloga J., Et al., Food allergies resulting from immunological cross-reactivity with inhalant allergens: guidelines from the German society for allergology and clinical immunology (DGAKI), the German dermatology society (DDG), the association of German allergologists (AeDA) and the society for pediatric allergology and environmental medicine (GPA), Allergo J Int, 23, pp. 1-16, (2014)

[4]

Dua S., Ruiz-Garcia M., Bond S., Durham S.R., Kimber I., Mills C., Et al., Effect of sleep deprivation and exercise on reaction threshold in adults with peanut allergy: a randomized controlled study, J Allergy Clin Immunol, 144, pp. 1584-1594.e2, (2019)

[5]

Worm M., Reese I., Ballmer-Weber B., Beyer K., Bischoff S.C., Classen M., Et al., Guidelines on the management of IgE-mediated food allergies: S2k-guidelines of the German society for allergology and clinical immunology (DGAKI) in collaboration with the German medical association of allergologists (AeDA), the German professional association of pediatricians (BVKJ), the German allergy and asthma association (DAAB), German dermatological society (DDG), the German society for nutrition (DGE), the

[6]

Martin P.E., Eckert J.K., Koplin J.J., Lowe A.J., Gurrin L.C., Dharmage S.C., Et al., Which infants with eczema are at risk of food allergy? Results from a population-based cohort, Clin Exp Allergy, 45, pp. 255-264, (2015)

[7]

Du Toit G., Roberts G., Sayre P.H., Plaut M., Bahnson H.T., Mitchell H., Et al., Identifying infants at high risk of peanut allergy: the learning early about peanut allergy (LEAP) screening study, J Allergy Clin Immunol, 131, (2013)

[8]

Stiefel G., Anagnostou K., Boyle R.J., Brathwaite N., Ewan P., Fox A.T., Et al., BSACI guideline for the diagnosis and management of peanut and tree nut allergy, Clin Exp Allergy, 47, pp. 719-739, (2017)

[9]

Ahrens B., Niggemann B., Wahn U., Beyer K., Organ-specific symptoms during oral food challenge in children with food allergy, J Allergy Clin Immunol, 130, pp. 549-551, (2012)

[10]

Vereda A., van Hage M., Ahlstedt S., Ibanez M.D., Cuesta-Herranz J., van Odijk J., Et al., Peanut allergy: Clinical and immunologic differences among patients from 3 different geographic regions, J Allergy Clin Immunol, 127, pp. 603-607, (2011)

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