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Evid Based Nurs 4:91 doi:10.1136/ebn.4.3.91
  • Prognosis

Children's adverse reactions to subsequent peanut exposure were often more serious than symptoms experienced in initial reactions


 
 QUESTION: In young children with peanut allergy, what is the nature and rate of adverse reactions caused by accidental peanut exposure?

Design

Prospective cohort study with a median of 5.9 years (range 1.4–22.4 y) of follow up.

Setting

Boulder, Colorado, USA.

Patients

102 children with clinical peanut hypersensitivity diagnosed before their fourth birthday. Children were included if they had a convincing history of clinical peanut hypersensitivity, a positive double blind, placebo controlled food challenge response to peanuts, or both; and a positive skin prick test response to peanuts. 83 children (81%) (median age 2.4 y, 69% boys) were included in the analysis.

Assessment of prognostic factors

Severity of symptoms (non-life threatening or potentially life threatening) and organ system involvement (skin, respiratory, gastrointestinal, or other) with symptoms experienced after accidental peanut exposure. Serum peanut specific immunoglobulin E (IgE) concentrations were measured in 51 of 83 (61%) children.

Main outcome measure

Subsequent adverse reactions after …

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