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Subsequent reactions were common and often more serious than the initial reactions of children with peanut allergy

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 QUESTION: In young children with peanut allergy diagnosed before 4 years of age, what is the nature and rate of adverse reactions caused by accidental peanut exposure?

Design

Cohort study with a median of 5.9 years (range 1.4 to 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 or a placebo controlled food challenge response to peanuts, or both; and a positive skin prick test response to peanuts. Data for 83 children (81%) (median age 2.4 y, 69% boys) were available for the analysis.

Assessment of prognostic factors

Initial assessment records: severity of symptoms (non-life threatening or potentially life threatening); organ system involvement (skin, respiratory, gastrointestinal, or other); and serum peanut specific immunoglobulin E (IgE) concentrations (in 51 of 83 [61%] children).

Main outcome measures

Subsequent adverse reactions after a first peanut exposure were assessed at least …

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