This case involved a 17-month-old boy with atopic dermatitis (eczema) and what was thought to be peanut allergy based on a skin test and blood test. The boy had two prior small rashes on his mouth after eating peanut.
“We weren’t convinced he was allergic to peanut because although his prior skin prick and blood testing suggested he was sensitive to peanut, he’d never had a convincing allergic reaction,” says allergist Katherine Tison, MD, ACAAI member and lead author of the study. “We performed an OFC, and he passed with only a small rash on his face which resolved itself. That showed he was sensitive to peanut, but not allergic. The case shows that an OFC should be used to determine if a child is truly allergic, especially prior to starting oral immunotherapy treatment, which was being considered for this child. A sensitivity shown through a skin prick or blood test is not enough to diagnose a food allergy.”
Following the successful OFC, the allergists did not recommend treatment but instead encouraged the parents to begin giving the child peanut products three times weekly to maintain his tolerance to peanut.
Presentation Title: A Case for Oral Challenge in Patients with High Peanut Sensitivity to Guide Treatment Decisions
Presenter: Katherine Tison, MD