title: Mono-sensitisation to peanut component Ara h 6: a case series of five children and literature review.
abstract: Here, we summarise the current clinical knowledge on Ara h 6 sensitisation and clinical relevance of this sensitisation pattern using five illustrative clinical cases. The literature search yielded a total of 166 papers, and an additional relevant article was found by 'snowballing'. A total of ten articles were considered relevant for this review. Most studies included patients with a sensitisation to Ara h 6 and cosensitisation to Ara h 2. Only three studies showed patients with a mono-sensitisation to Ara h 6. This illustrates that Ara h 6 mono-sensitisation has been neglected in literature. We present a case series of five children with sensitisation to peanut component Ara h 6. Only one of these five patients showed Ara h 8 cosensitivity. Three out of the five children had a positive double-blind placebo-controlled food challenge (DBPCFC), with moderate to strong reactions.
  
  
  CONCLUSIONS
  A mono-sensitisation to peanut component Ara h 6 is uncommon but can cause severe allergic reactions. Therefore, the determination of sIgE to Ara h 6 is warranted in patients with a suspected peanut allergy, especially in the absence of sensitisation to Ara h 1, 2, 3 and 9.
  
  
  BACKGROUND
  • Peanut allergy is common and can cause severe allergic reactions. • The diagnostics of peanut allergy has recently improved with the use of component resolved diagnosis What is new: • A mono-sensitisation to peanut component Ara h 6 is uncommon, but can cause severe allergic reactions • Determination of sIgE to Ara h 6 is warranted in patients with a suspected peanut allergy, especially in the absence of sensitisation to Ara h 1, 2, 3 and 9.
authors.affiliation: Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands. j.p.m.vandervalk@erasmusmc.nl.
authors.forename: J P M
authors.initials: JPM
authors.lastname: van der Valk
authors.affiliation: Department of Immunology, Laboratory Medical Immunology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: M W J
authors.initials: MWJ
authors.lastname: Schreurs
authors.affiliation: Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: El Bouch
authors.affiliation: Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands.|Department of Paediatric Allergology, Diaconessenhuis Voorburg, Reinier de Graaf Group, Delft, The Netherlands.
authors.forename: N J T
authors.initials: NJT
authors.lastname: Arends
authors.affiliation: Department of Internal Medicine, section of Allergology, Erasmus MC, Office Gk 323, P.O. box 2040, 3000CA, Rotterdam, The Netherlands.
authors.forename: N W
authors.initials: NW
authors.lastname: de Jong
mesh_terms: D055516:2S Albumins, Plant / Q000276:immunology*; D000293:Adolescent; D052179:Antigens, Plant / Q000276:immunology*; D002648:Child; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000276:immunology
chemical_list: D055516:2S Albumins, Plant; D052179:Antigens, Plant; C492737:Ara h 6 allergen, Arachis hypogaea; D007073:Immunoglobulin E
keywords: Ara h 6; Components; Double-blind placebo-controlled food challenge (DBPCFC); Peanut allergy