August 08, 2014
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Children with peanut allergies tolerated boiled peanut

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Children with peanut allergies experienced varying degrees of tolerance to boiled peanut, according to recent study results.

Researchers reported on four children with peanut allergies. A 14-year-old girl had egg, cow’s milk, cashew and pistachio allergies and avoided peanut, based on skin prick test, serum-specific IgE (ssIgE) to peanut, and Ara h 2 indicative of a greater than 95% likelihood of clinical reaction. Increasing doses of daily boiled peanut — initially boiled for 16 hours, reduced to 2 hours and then 30 minutes — were successfully tolerated. The patient transitioned to daily raw peanut, with minor allergic symptoms, during a 2-year period.

A 12-year-old boy had an oral food challenge (OFC) reaction to roasted peanut (ssIgE to peanut 9.6 kU/L) in 2010, and had persistent sensitization, suggesting ongoing allergy. His brother, aged 15 years, “had a history of acute-onset, generalized urticaria following exposure to a small amount of peanut as an infant, with persisting sensitization thereafter (ssIGE to peanut 7.5 kU/L; ara h 2 12.3 kU/L in April 2013).”

The younger patient tolerated 2 g boiled peanut (initially boiled for 4 hours and reduced to 1 hour) daily after 8 months, while his brother reacted to 2 g boiled peanut during updosing, but remained tolerant to 0.5 g boiled peanut daily.

A 10-year-old girl was allergic to egg, milk and tree nuts and avoided peanuts based on persistent large skin prick test. During OFC, she tolerated 8 g peanut, boiled for 2 hours; according to serum obtained at that time, ssIgE to peanut (19.5 kU/L) and Ara h 2 (13.2 kU/L) indicated a greater than 95% likelihood of clinical reactivity.

“We believe that exposure to boiled peanut may permit the ingestion of low amounts of proteins (including 2S albumins), which may be an alternative means by which desensitization can be induced in patients allergic to peanut, with potential for increased safety and decreased breakthrough allergic symptoms,” the researchers concluded.

 

Disclosure: See the study for a full list of relevant financial disclosures.