A 5-year retrospective review of children with peanut allergy in the largest paediatric hospital in Singapore

Abstract

Background: The prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children. Objective: To describe the demographic characteristics and clinical features of children with PA. Methods: This is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results. Results: There were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13-39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy-75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma. Conclusion: This is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.

Ways of Optimizing the Diagnostics of Food Allergies in Children Based on the Clinical and Immunological Criteria

“…In isolated cases, the initial manifestations of laryngeal edema were observed, which led to difficulty breathing in 16% of children with gastroduodenal pathology against 10% of patients with atopic dermatitis. However, as the results of our study show, the frequency of anaphylactic reactions was significantly lower as compared to Western countries (23.7-34.9%) [3,5,6].…”

From Allergen Molecules to Molecular Immunotherapy of Nut Allergy: A Hard Nut to Crack

“…In Asia, peanut allergy prevalence seems to be low compared to US and certain western countries (76,(89)(90)(91)(92). Cashew nut is one of the most common reported tree nuts causing allergy in Asia (67,70,71,74). However, tree nut allergy prevalence varies significantly across Asia especially between East and Southeast Asia and the Middle East (62,63,66,70,74).…”

“…Cashew nut is one of the most common reported tree nuts causing allergy in Asia (67,70,71,74). However, tree nut allergy prevalence varies significantly across Asia especially between East and Southeast Asia and the Middle East (62,63,66,70,74). It can be assumed that the availability of nuts in certain regions contributes to the prevalence of allergies to these nuts, as can be seen by the increased frequency of pistachio allergy in pistachio cultivation regions (64).…”

The Interplay of Nutriepigenomics, Personalized Nutrition and Clinical Practice in Managing Food Allergy

“…With food being the main culprit in this disease, the differences in dietary habits in different races and regions of the world have influenced the list of common allergens within the particular region or race [17]. For example, the incidence of peanut allergy is not highly prevalent in the Southeast Asia population compared to Western countries, while the incidence of allergy towards cashew nuts was observed to be comparatively higher among children from the Southeast Asia region [18][19][20]. Nonetheless, the main allergens remain largely true to most parts of the world, with eggs, milk, fish, and shellfish being the top four main food allergens, while peanuts, tree nuts, soybeans and wheat are the next four items, thus completing "the big eight" common food allergens [21][22][23].…”