TUESDAY, Nov. 9 (HealthDayNews) -- If your child
outgrows a peanut allergy, he or she should have foods
containing peanuts at least once a month to prevent the
allergy from returning, a new study suggests.
According to the results of the research, eating
something with peanuts at least that often will help
maintain a tolerance to them. But even though the
allergy has apparently disappeared if the amount of
peanuts eaten is limited, children should carry
epinephrine for a while just in case a reaction
develops.
"We were surprised a few years ago to discover that
some children who had lost their peanut allergy got it
back," said lead researcher Dr. Robert A. Wood, a
professor of pediatrics at Johns Hopkins University. "We
were surprised because that is something we had not seen
with other food allergies."
In their study, Wood and his team studied 68 children
who had outgrown their allergy to peanuts. The purpose
of the study was to find out how many of the children
became allergic again.
They also wanted to identify the risk factors that
caused the allergy to recur, and to find ways to treat
children who had outgrown their allergic reaction to
peanuts, according to their report in the November issue
of the Journal of Allergy & Clinical
Immunology.
Wood's group looked at repeat peanut-specific
immunoglobin-E (IgE) levels, did food challenges with
peanuts, and had the children answer questions about
what they ate.
The researchers found there was about an 8 percent
chance of having a recurrence of peanut allergy. The
risk of recurrence was much higher among children who
avoided eating peanuts after they had outgrown the
allergy, Wood's group reported.
"It is much less likely to get the allergy back if
you are eating peanut on a regular basis once you have
been able to tolerate peanut," Wood said.
Wood said that peanut is not unique. It is likely the
same thing happens with other food allergies, such as
milk or eggs. "The big difference is that when someone
outgrows their milk allergy, even if they are not a big
milk drinker, they are getting milk protein in their
diet on a daily basis," he said.
"It is more common for people who have had a peanut
allergy to still avoid the food even though we have told
them they can put it back into their diet," Wood
added.
"We now recommend that our patients eat concentrated
forms of peanut at least once a month after outgrowing
their peanut allergy in an attempt to maintain peanut
tolerance," Wood's team wrote.
"We also recommend that patients and families who eat
peanut frequently continue to carry injectable
epinephrine for at least one year after passing their
challenge. If they eat peanut only infrequently or in
limited amounts, then patients should have epinephrine
available indefinitely at all times because of their
increased risk of recurrent allergy," the researchers
concluded.
Wood noted that all allergies are on the rise in
developed countries, but are almost unheard of in
developing countries. Part of this increase can be
explained by the so-called hygiene theory, he said.
"The less an infant is exposed to germs and
infections, the more their immune systems can focus on
things like allergy," Wood said. "Allergies are much
less common if you grow up on a farm, have close contact
with animals; the more exposure you have to bacteria and
other infections early in life, the less likely you are
to have allergies," he added.
"While peanut allergy was often considered to be
lifelong, studies from several centers have shown that
about 20 percent of young children with the allergy are
able to consume peanut at school age," said Dr. Scott H.
Sicherer, an associate professor of pediatrics from the
Jaffe Food Allergy Institute at Mount Sinai School of
Medicine.
"This exciting discovery is tempered by the
observation, reported by our group and several others,
that some of the children eventually had a recurrence of
the allergy," he added.
In Sicherer's practice, he monitors young children
with peanut allergy to see if they outgrow it. "When we
plan to have the child eat peanut under doctor
supervision, we explain to families that we would have
them truly add peanut to the diet if they successfully
tolerate the food," he said.
In addition, when a child successfully ingests
peanut, he has the family give peanut and has them no
longer avoid the food. Not doing this seems to increase
the risk that the allergy could recur. "We have them
continue to have emergency medication available for a
year or two until it is clear the child is eating peanut
routinely. If the child refuses to eat peanut, we would
need to test them periodically to know if a danger has
re-emerged," Sicherer said.
More information
The National Institute of Allergy and Infectious
Diseases has a primer on food allergies.