[Peanut allergy, not always the correct diagnosis].
BACKGROUND
Diagnosing peanut allergy in children is complicated. The clinical history can be difficult to interpret, measurement of peanut-specific immunoglobulin E (IgE) is of limited usefulness due to its poor specificity, and the gold standard (double-blind placebo-controlled food challenge) is time-consuming and labour-intensive, limiting its use in daily practice. Under-diagnosing peanut allergy is considered dangerous, because of serious reactions like anaphylaxis. As a result, there is a high probability of over-diagnosis of peanut allergy in the general population, leading to unnecessary peanut-free diets and parental anxiety.


METHODS
We discuss three children diagnosed with peanut allergy, and describe the clinical and diagnostic considerations of peanut allergy. After a detailed history focusing on the reproducibility of objective symptoms after exposure, peanut allergy was excluded in two cases allowing normalization of the diet and reduction of patient and parental anxiety.


CONCLUSIONS
A detailed history, focusing on reproducible and objective symptoms, is helpful in confirmation or exclusion of the diagnosis 'peanut allergy' and can thus prevent unnecessary peanut-free diets.
Amalia Kindcentrum, Isala, Zwolle.
Wilma J
WJ
van Veen
Paul L P
PL
Brand
D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008487:Medical History Taking; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology
D007073:Immunoglobulin E