A case report of mono-sensitization to peanut component Ara h6

Authors

  • Maria G. Bartellino Department of Pediatrics, Goryeb Children’s Hospital at Morristown Medical Center, Morristown, New Jersey, USA
  • Lisa Barisciano Department of Pediatrics, Goryeb Children’s Hospital at Morristown Medical Center, Morristown, New Jersey, USA

DOI:

https://doi.org/10.18203/2349-3291.ijcp20192051

Keywords:

Arachis hypogaea, Component testing, Peanut allergy

Abstract

Peanut is the most common food allergen in the US, affecting 1-2 % of the population and studies show that it is still on the rise.  Component testing has offered better insight into the likelihood of reactivity with exposure. Extensive literature shows Arachis hypogea (Ara h) 2 as being the most clinically significant component identified to correlate with reactivity with exposure to the peanut protein, however there is minimal research on the reactivity of Ara h6. This case report describes a patient with a clinical reaction to peanut as a toddler and subsequent positivity on annual skin testing with commercial peanut extract, likely confounded by positive birch with advancing age. Immuno CAP testing revealed a negative Ara h2 and positive Ara h6, describing mono-sensitization to Ara h 6 and high probability of clinical reactivity. The importance of this case is to raise awareness of other highly allergenic components in patients with peanut allergy.

References

Sicherer SH, Muñoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clinic Immunol. 2003;112(6):1203-7.

Grundy J, Matthews S, Bateman B, Dean T, Arshad SH. Rising prevalence of allergy to peanut in children: data from 2 sequential cohorts. Journal of Allergy Clinic Immunol. 2002;110(5):784-9.

Taylor SL, Baumert JL, Kruizinga AG, Remington BC, Crevel RW, Brooke-Taylor S, et al. Establishment of reference doses for residues of allergenic food: report of the vital expert panel. Food Chem Toxicol. 2013;63:9-17.

Asarnoj A, Östblom E, Ahlstedt S, Hedlin G, Lilja G, Van Hage M, et al. Reported symptoms to peanut between 4 and 8 years among children sensitized to peanut and birch pollen-results from the BAMSE birth cohort. Allergy. 2010;65(2):213-9.

Mueller GA, Maleki SJ, Pedersen LC. The molecular basis of peanut allergy. Curr Allergy Asthma Reports. 2014;14(5):429.

Flinterman AE, Knol EF, Lencer DA, Bardina L, den Hartog Jager CF, Lin J, et al. Peanut epitopes for IgE and IgG4 in peanut-sensitized children in relation to severity of peanut allergy. J Allergy Clinic Immunol. 2008;121(3):737-43.

Kukkonen AK, Pelkonen AS, Mäkinen‐Kiljunen S, Voutilainen H, Mäkelä MJ. Ara h 2 and Ara 6 are the best predictors of severe peanut allergy: a double‐blind placebo‐controlled study. Allergy. 2015;70(10):1239-45.

Klemans RJ, van Os‐Medendorp H, Blankestijn M, Bruijnzeel‐Koomen CA, Knol EF, Knulst AC. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy: a systematic review. Clin Exp Allergy. 2015;45(4):720-30.

Uotila R, Kukkonen AK, Blom WM, Remington B, Westerhout J, Pelkonen AS, et al. Component‐resolved diagnostics demonstrates that most peanut‐allergic individuals could potentially introduce tree nuts to their diet. Clin Exp Allergy. 2018;48(6):712-21.

Van der Valk JP, Schreurs MW, El Bouch R, Arends NJ, De Jong NW. Mono-sensitisation to peanut component Ara h 6: a case series of five children and literature review. Eur J Pediatr. 2016;175(9):1227-34.

Palladino C, Breiteneder H. Peanut allergens. Mol Immunol. 2018;100:58-70.

Verhoechx KCM, Vissers YM, Baumert JL, Faludi R, Feys M, Flanagan S, et al. Food processing and allergenicity. Food Chemic Toxicol. 2015;80:223-40.

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Published

2019-04-30

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Section

Case Reports