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AND THE ANSWERS ARE . . .
- The serum level of IgE antibodies against the major peanut allergen helps predict whether the patient has clinically manifest PA.
True
- Boiled peanuts are more allergenic than roasted peanuts.
False
- There is an increased incidence of allergy to true nuts in those with PA.
True
- Rubbing of the hands with a disinfectant lotion after handling peanuts will get rid of peanut allergens.
False
- In almost all cases PA in children persists into adulthood.
False
Discussion
Not all children with positive skin tests to peanut allergen or elevated serum levels of IgE anti-peanut antibodies have clinically manifest PA. However, studies by several groups have shown that the higher the levels of IgE anti-peanut antibodies, the more likely clinical PA is present. For example, studies by Sampson, Sicherer and colleagues in New York have shown that patients with peanut prick skin test responses of at least 8 mm diameter or serum levels of IgE anti-peanut antibodies of at least 15k U/ml (detected using a Pharmacia CAP-RAST technique) have an over 90% likelihood of clinically manifest PA.
PA appears to be more common in populations where roasted rather than boiled peanuts are the predominant method of peanut preparation.
Although peanuts are legumes, not true nuts, studies by Sampson's group have shown that up to 35% of children with PA eventually manifest allergy to one or more tree nuts.
Recent studies by a group in Johns Hopkins Medical Institutions have shown that thorough hand washing with bar soap, but not rubbing with a disinfectant lotion gets rid of almost all, if not all, peanut allergen.
For years, it was thought that almost all children with PA continue to exhibit this allergy in adulthood. However, recent studies by at least 2 groups have shown that clinically manifest PA subsequently remits by adolescence/adulthood in up to 20% of children with PA.
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