Diagnosis of peanut allergy

Abstract

It is nowadays possible to determine specific IgE (sIgE) to the individual allergenic peanut components instead of sIgE to peanut extract. The aim of this study was to assess the diagnostic value of sIgE to Ara h 1, Ara h 2, Ara 3, Ara h 8 and Ara h 9 in both children and adults suspected of peanut allergy. 100 children and 94 adults were included, who all had undergone a food challenge with peanut. sIgE to the peanut components was measured by ImmunoCAP. The diagnostic value was assessed by the 'Area Under the ROC Curve' (AUC). sIgE to Ara h 2 had the best diagnostic value of all peanut components in both children (AUC 0.90) and adults (AUC 0.75) and was a better predictor than the currently used sIgE to peanut extract and the skin prick test (0.85 and 0.83 in children and 0.70 and 0.72 in adults). By using sIgE to Ara h 2 cut-off values could be calculated that diagnosed peanut allergy with 100% certainty (in 26% of both children and adults) or that excluded peanut allergy with 100% certainty (only in children: 24%).© 2014 De Nederlandse Vereniging voor Dermatologie en Venereologie.