The management of peanut allergy

Abstract

Peanut allergy is common and can be a cause of severe, life-threatening reactions. It is rarely outgrown like other food allergies such as egg and milk. Measures aiming to reduce its prevalence via maternal avoidance during pregnancy and lactation, or delayed introduction into the diet, have failed to show any benefit. Peanut allergy has a significant effect on the quality of life of sufferers and their families due to dietary and social restrictions, but mainly stemming from fear of accidental peanut ingestion. The current management consists of strict avoidance, education and provision of emergency medication. Families find avoidance challenging as peanut is hidden in various food products. Despite the fact that food labelling has improved, with a legal obligation to declare certain food allergens (including nuts) in prepacked products, it still causes confusion and does not extend to cross-contamination. In an effort to address issues of safety at school, a lot of work has been undertaken to better care for peanut-allergic children in that environment. This includes training of school staff on how to recognise and treat allergic reactions promptly. Recent developments in the management of peanut allergy, such as immunotherapy, have shown some promise as an active form of treatment, but larger studies are required to further investigate safety and efficacy.

Peanut allergy as a family project: social relations and transitions in adolescence

“…Peanut allergy is known to have impact on adolescents' quality of life (Flokstra-de Blok et al 2008, van der Velde et al 2011 and is rarely outgrown, in contrast to other food allergies such as egg and milk (Anagnostou & Clark 2015). It is unusual in that the individual has a chronic condition but remains well, though with the potential to become acutely and severely ill due to anaphylaxis (Cummings et al 2010).…”

Mono-sensitisation to peanut component Ara h 6: a case series of five children and literature review

“…Even a tiny amount of peanut allergen can induce allergic reactions, including anaphylaxis. The majority of peanut-allergic patients remain allergic to peanuts for the rest of their lives [3]. Diagnosis is traditionally based on the clinical history, sensitisation (skin prick test (SPT) and/or specific IgE (sIgE) and optionally, a double-blind placebo-controlled food challenge (DBPCFC) test [26].…”

The role of environmental exposure to peanut in the development of clinical allergy to peanut

“…71 Thus, although environmental exposure to peanut (in the form of quantifiable peanut on household surfaces and dust or household consumption of peanut during infancy) does seem to be associated with an increased risk of peanut sensitization and PA in certain high risk groups, exposure via the oral route has a more important role in the child developing peanut tolerance. 72,73 The oral tolerance induction route therefore seems to be a much stronger effect than the sensitizing effect of cutaneous exposure.…”