Lupin allergy in peanut-allergic children and teenagers.
BACKGROUND
Lupin has now been introduced into food production in the UK. There is a concern that, on account of cross-reactivity, peanut-allergic children are at high risk for lupin allergy.


OBJECTIVE
To investigate the prevalence of lupin sensitization and allergy in children with peanut allergy compared with atopic controls.


METHODS
Children (<18 years) were recruited. Peanut-allergic subjects either had a convincing history of peanut allergy with diagnostic peanut skin prick test (SPT) or specific-immunoglobulin E (IgE) results or a positive food challenge. Control subjects were atopic but not peanut-allergic. All subjects had SPT to peanut and lupin. Sensitized subjects were offered a randomized, double-blind, placebo-controlled lupin challenge. Lupin allergy was defined as objective immediate hypersensitivity reaction at food challenge.


RESULTS
Forty-seven peanut-allergic children and 46 atopic controls were recruited. Sixteen peanut-allergic children were sensitized to lupin [34%, 95% confidence interval (CI): 21-49%]. Nine were challenged to lupin. Two reacted (itchy mouth and urticaria; itchy mouth and 20% drop in peak expiratory flow rate) giving a minimum prevalence of lupin allergy in peanut-allergic children of 4.0% (95% CI: 1-15%). Atopic controls were significantly (P = 0.001) less likely to be sensitized to lupin (4%, 95% CI: 1-15%) and had smaller wheals and serum-specific IgE results. None of the atopic controls reacted on lupin challenge, giving a rate of allergy in the atopic controls of 0% (95% CI: 0-8%).


CONCLUSIONS
A small but significant number of children with peanut allergy are allergic to lupin. Sensitization to lupin is much rarer in nonpeanut-allergic atopic subjects.
Shaw
J
J
University Child Health, University of Southampton, Southampton, UK.
Roberts
G
G
Grimshaw
K
K
White
S
S
Hourihane
J
J
D000293:Adolescent; D000485:Allergens; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000276:immunology*; D031297:Lupinus / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000379:methods*; D006113:United Kingdom
D000485:Allergens; D007073:Immunoglobulin E