To test or not to test: Lessons learned from screening infants for peanut allergy.

IF 2.6 3区 医学 Q2 ALLERGY
Emily Engelhardt, Benjamin T Prince, David R Stukus, Elizabeth Messeh, Irene Mikhail
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Abstract

Background: In recent years, there has been a trend to forgo screening for peanut allergy (PA), even in infants at high risk. This study aimed to better understand the implications of screening for PA before peanut introduction. Objective: We sought to characterize the outcomes of infants who underwent PA skin testing in a tertiary-care allergy clinic. Methods: We performed a retrospective chart review between July 1, 2017, and December 31, 2020, on all infants seen in the allergy clinic who had a peanut skin-prick test and recorded their demographic and clinical characteristics as well as outcomes with regard to PA and tolerance. Results: Twenty percent of the infants screened were identified as having PA. Infants with a PA were more likely to be older at the time of testing, more likely to have another allergist-diagnosed immunoglobulin E (IgE) mediated food allergy, and more likely to have a prescription for a stronger (class VI or stronger) topical steroid. When conducted, oral food challenge was safe, with the majority of infants being treated with observation or antihistamines. A large percentage of infants with a PA developed tolerance during the follow-up period. Conversely, 5% of the infants who were initially tolerant developed a new PA. Conclusion: PA is associated with severe atopic dermatitis and other IgE-mediated food allergies. However, it is unclear if there is a benefit from screening infants before peanut introduction. It is important to monitor for resolution in the infant population.

测试或不测试:从筛选婴儿花生过敏的经验教训。
背景:近年来,有放弃花生过敏筛查(PA)的趋势,即使是高危婴儿。本研究旨在更好地了解花生引入前PA筛查的意义。目的:我们试图描述在三级护理过敏诊所接受PA皮肤试验的婴儿的结果。方法:我们对2017年7月1日至2020年12月31日期间在过敏诊所接受花生皮肤点刺试验的所有婴儿进行了回顾性图表回顾,并记录了他们的人口统计学和临床特征以及与PA和耐受性相关的结果。结果:20%的筛查婴儿被确定为PA。患有PA的婴儿更有可能在测试时年龄较大,更有可能有其他过敏症专家诊断的免疫球蛋白E (IgE)介导的食物过敏,更有可能有更强(VI类或更强)的局部类固醇处方。当进行时,口服食物挑战是安全的,大多数婴儿接受观察或抗组胺药治疗。很大一部分患有PA的婴儿在随访期间产生了耐受性。相反,最初耐受的婴儿中有5%发展为新的PA。结论:PA与严重特应性皮炎及其他ige介导的食物过敏有关。然而,目前尚不清楚在引入花生之前对婴儿进行筛查是否有好处。重要的是监测婴儿群体的解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.70
自引率
35.70%
发文量
106
审稿时长
6-12 weeks
期刊介绍: Allergy & Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists. The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma. Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.
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