The natural history of peanut sensitization and allergy in a birth cohort

Of those with sensitization at age 4 years (n = 10), 4 (40%) had PA, whereas at age 18 years, only 2 (4.76%) of 42 children with new-onset sensitization had PA (P = .009). [...]the increase in the number of subjects sensitized to peanut during adolescence was largely due to the onset of asymptomatic sensitization. Peanut sensitization 4 y (n = 13) 10 y (n = 19) 18 y (n = 54) Sensitization to any aeroallergen 11 (84.6%) 17 (89.5%) 52 (96.3%) Sensitization to grass pollen mix 6 (46.2%) 12 (63.2%) 47 (87.0%) Sensitization to tree pollen mix Not done 3 (15.8%) 27 (50.0%) Sensitization to any food allergen 3 (23.1%) 5 (26.3%) 48 (88.9%) Sensitization to wheat 0 3 (15.8%) 47 (87.0%) Sensitization to soya 1 (7.7%) 1 (5.3%) 4 (7.4%) Asthma 6 (46.2%) 6 (31.6%) 23 (42.6%) Eczema 8 (61.5%) 6 (31.6%) 7 (13.0%) Rhinitis 3 (23.1%) 10 (52.6%) 47 (87.0%) Table E3 Associated allergic sensitization and clinical allergic conditions in those with peanut sensitization at each age Subjects 4 y 10 y 18 y Nature of worst allergic reaction 1 PA PA PA Oral symptoms, vomiting, urticaria, and anaphylaxis 2 PA PA PA Anaphylaxis within an hour of peanut ingestion 3 PA PA PA Vomiting within an hour of peanut ingestion 4 PA PA Missing Urticarial rash within 1 h of peanut ingestion 5 PA PA No PA Urticarial rash and throat tightness within 1 h of peanut ingestion 6 PA No PA No PA Urticaria within 1 h of peanut ingestion 7 No PA AS PA Immediate throat tightness, wheezing, generalized urticaria, and anaphylaxis 8 No PA No PA PA Urticaria and wheeze, progressing to anaphylaxis 9 No PA No PA PA Anaphylaxis 10 AS PA Missing (died) Immediate vomiting with peanut; died at age 11 y of acute asthma attackE9 Table E4 Natural history of clinical PA Notes: Of 6 patients with PA at age 4 years, 5 persisted to 10 years, and 1 outgrew PA.