Peanut Allergy May Not Be a Life Sentence
Feb. 12, 2001 -- If you or your child has a peanut allergy, you may feel that you've received a life sentence. You're probably wedded to an epinephrine kit, and you read food labels as a daily activity. Even so, you know that accidental exposure is always possible. With varying amounts of grace and irritation, you've probably accepted this scenario as your fate.
For a minority of peanut-allergic people, the condition may be temporary. According to a study in the most recent issue of the Journal of Allergy and Clinical Immunology, more than 20% of children with diagnosed peanut allergy may go on to outgrow the condition.
"The diagnosis of peanut allergy carries with it great medical and emotional significance," the authors write. "Patients and their families are advised to be extremely cautious with all foods consumed and that peanut allergy reactions can be severe and even fatal."
Allergic reactions to peanuts can range from hives and a runny nose to anaphylaxis, a potentially life-threatening emergency. And with more people adopting a vegetarian diet, and as prepared foods have become a staple of the modern kitchen, peanuts are becoming more common in food products, increasing the risk of accidental ingestion.
Researcher Robert A. Wood, MD, says two issues made his team think the notion you can never outgrow peanut allergy was wrong. "First, we saw a number of patients in our regular follow-up of food-allergic children who appeared to be losing peanut allergy," Wood tells WebMD. "Second, some patients who had accidental ingestion didn't have the bad reaction we would have expected." Wood is a pediatric allergist and an associate professor of pediatrics at Johns Hopkins University in Baltimore.
In this study, he and his colleagues recruited more than 200 people 4 to 20 years old who had been diagnosed with peanut allergy on the basis of a prior acute reaction, positive skin or blood tests, or a positive peanut challenge. Of these, 85 participants underwent an oral peanut challenge, in which they ate a peanut product in a clinical setting. The rest were excluded because they were either highly allergic, had had a reaction to peanut within the past year, or refused the test.
Among the 85 patients who took the oral peanut challenge, close to half tolerated the challenge and were therefore considered to have outgrown their peanut allergy.
People with peanut allergy should be reevaluated regularly, perhaps every one to two years, "in order to identify those who have lost their allergy," Wood says. "Although a minority of peanut-allergic patients may outgrow their allergy ... it would make an enormous difference to not have to take precautions against peanut exposure. For a lot of peanut-allergic people, this issue runs their lives."