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Ann Allergy Asthma Immunol. 2012 May;108(5):332-6. doi: 10.1016/j.anai.2012.03.010.

Clinical thresholds to egg, hazelnut, milk and peanut: results from a single-center study using standardized challenges.

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1
Department of Dermatology and Allergy Centre, Odense University Hospital, Sdr. Boulevard 29, Odense, Denmark.

Abstract

BACKGROUND:

Large studies of individual thresholds and risk profiles for foods are sparse. Previous reports indicate that thresholds adjusted for the protein content in foods would be comparable.

OBJECTIVE:

To establish and compare clinical threshold values for egg, hazelnut, milk and peanut, and correlating them to severity of symptoms.

METHODS:

Seven hundred eighty-one challenges were performed in 487 patients (age range, 0.5-73.5 years). Using interval censoring survival analysis, the dose distribution of thresholds was fitted to a log-normal function. Symptom score was correlated to thresholds.

RESULTS:

Based on the 405 challenges resulting in objective signs, similar distribution of thresholds for hazelnut, milk, and peanut challenges were found, whereas individuals with egg allergy were bimodally distributed with a high or a low threshold. Eliciting dose in 10% (95% confidence interval) was 42.9 (24-76.8) mg whole eggs, 133.8 (95.9-186.6) mg whole hazelnut, 106.5 (59.7-190.6) mg roasted peanut, and 2.9 (1.5-5.4) mL milk. Adults showed more severe symptoms and signs than children, and peanut caused more severe reactions than the 3 other foods.

CONCLUSION:

Thresholds for the different foods were not comparable, and eliciting dose for the 4 foods differed, even if adjusted for protein content. Increasing age but not a low threshold dose is associated with severe symptoms on challenge. Peanuts elicit more severe reactions than the other foods.

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PMID:
22541404
DOI:
10.1016/j.anai.2012.03.010
[Indexed for MEDLINE]

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