The Utility of Peanut Components in the Diagnosis of IgE-Mediated Peanut Allergy Among Distinct Populations

Jay Lieberman, Susanne Glaumann, Sofia Batelson, Magnus P. Borres, Hugh A. Sampson, Caroline Nilsson

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Background: Increasing data suggest that analysis of IgE to peanut components can be clinically helpful and possibly more accurate than IgE to whole peanut. Not all studies examining this topic, however, have used prospective samples, multiple components, and peanut challenges. Objective: We sought to determine the utility of peanut component testing, using a standardized, commercially available test done before oral peanut challenge in various populations of patients with suspected peanut allergy from 2 different countries. Methods: IgE to whole peanut and the recombinant allergen components Ara h 1, 2, 3, and 8 were analyzed from serum samples drawn before double-blind peanut challenge from 4 distinct cohorts of patients with suspected peanut allergy from 2 nations (United States and Sweden). Results: Patients (n = 167; median age, 11.7 years; interquartile range, 7.0-15.0 years) had serum analyzed for peanut components and completed an oral food challenge to peanut. Although IgE to peanut was the most sensitive test (0.93), Ara h 2 was the most specific (0.92) and provided the best positive predictive value (0.94) of all the tests. Ara h 2 was also the best overall diagnostic test by receiver operating characteristic analysis (area under the curve, 0.84; P < .05). Conclusions: In patients with suspected peanut allergy, IgE to peanut is a sensitive test but is not specific. IgE to Ara h 2 is a more specific and more accurate diagnostic test in this sampling of patients with suspected peanut allergy. Given each tests attributes, a stepwise approach to testing may provide clinicians with a way to minimize the need for peanut challenges.

Original languageEnglish (US)
Pages (from-to)75-82
Number of pages8
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume1
Issue number1
DOIs
StatePublished - Jan 1 2013

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Peanut Hypersensitivity
Immunoglobulin E
Population
Routine Diagnostic Tests
Arachis
Serum
Sweden
ROC Curve
Allergens

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy

Cite this

The Utility of Peanut Components in the Diagnosis of IgE-Mediated Peanut Allergy Among Distinct Populations. / Lieberman, Jay; Glaumann, Susanne; Batelson, Sofia; Borres, Magnus P.; Sampson, Hugh A.; Nilsson, Caroline.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 1, No. 1, 01.01.2013, p. 75-82.

Research output: Contribution to journalArticle

Lieberman, Jay ; Glaumann, Susanne ; Batelson, Sofia ; Borres, Magnus P. ; Sampson, Hugh A. ; Nilsson, Caroline. / The Utility of Peanut Components in the Diagnosis of IgE-Mediated Peanut Allergy Among Distinct Populations. In: Journal of Allergy and Clinical Immunology: In Practice. 2013 ; Vol. 1, No. 1. pp. 75-82.
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