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J Allergy Clin Immunol. 2017 Jan;139(1):29-44. doi: 10.1016/j.jaci.2016.10.010.

Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel.

Author information

1
National Institute of Allergy and Infectious Diseases, Bethesda, Md.
2
National Institute of Allergy and Infectious Diseases, Bethesda, Md. Electronic address: coopersu@niaid.nih.gov.
3
Board of Directors, Food Allergy Research & Education, McLean, Va.
4
Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.
5
Food Allergy Research & Education, McLean, and the Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Mich.
6
Department of Dermatology, University of Rochester Medical Center, NY.
7
National Eczema Association, San Rafael, Calif.
8
Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
9
Division of Allergy and Immunology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
10
Departments of Dermatology and Pediatrics, University of California, San Diego School of Medicine, Rady Children's Hospital, San Diego, Calif.
11
Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colo.
12
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of Kentucky College of Medicine, Kentucky Children's Hospital, Lexington, Ky.
13
Digestive Health Institute, Children's Hospital Colorado, Aurora, and the Section of Pediatric Gastroenterology, University of Colorado Denver School of Medicine, Aurora, Colo.
14
Division of Academic General Pediatrics and Primary Care, Department of Pediatrics, and the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill.
15
Northwestern Medicine, Central DuPage Hospital, Winfield, Ill.
16
Division of Allergy and Immunology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Ark.
17
Metro DC Food Allergy Support Group, Rockville, Md.
18
Food Allergy Referral Centre, Department of Women and Child Health, Padua University Hospital, Padua, Italy.
19
University of Missouri-Kansas City School of Medicine, Kansas City, Mo.
20
Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
21
Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
22
Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY.
23
Department of Pediatrics, Division of Dermatology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Wash.
24
Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa.
25
Department of Pediatrics, Section of Allergy and Immunology, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, Ohio.
26
Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
27
Departments of Medicine and Pediatrics, Harvard Medical School, Boston, Mass.

Abstract

BACKGROUND:

Food allergy is an important public health problem because it affects children and adults, can be severe and even life-threatening, and may be increasing in prevalence. Beginning in 2008, the National Institute of Allergy and Infectious Diseases, working with other organizations and advocacy groups, led the development of the first clinical guidelines for the diagnosis and management of food allergy. A recent landmark clinical trial and other emerging data suggest that peanut allergy can be prevented through introduction of peanut-containing foods beginning in infancy.

OBJECTIVES:

Prompted by these findings, along with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases facilitated development of addendum guidelines to specifically address the prevention of peanut allergy.

RESULTS:

The addendum provides 3 separate guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for introduction of peanut-containing foods in the health care provider's office or at home. The addendum guidelines provide the background, rationale, and strength of evidence for each recommendation.

CONCLUSIONS:

Guidelines have been developed for early introduction of peanut-containing foods into the diets of infants at various risk levels for peanut allergy.

KEYWORDS:

Food; allergy; guidelines; peanut; prevention

PMID:
28065278
PMCID:
PMC5226648
DOI:
10.1016/j.jaci.2016.10.010
[Indexed for MEDLINE]
Free PMC Article

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