Peanut sensitization, the relationship with peanut-related symptoms and asthma in children

The diagnosis of food allergy is complicated. The patient*s medical history as
obtained by a relative is often unreliable and laboratory tests can only show
sensitization. While double-blind placebo-controlled food challenges remain
the "gold standard" in food allergy diagnosis, logistic and practical
difficulties make it less applicable for daily practice. As a result, the test
is not used often, possibly causing many false positive diagnoses of food
allergy in children, unnecessary elimination diets and their consequences.
The exact association between food related symptoms, sensitization and food
allergy is currently unknown.
Food allergy is part of the atopic syndrome. It is known that children with
asthma and food allergy have an increased risk of developing an anaphylactic
reaction after exposure to the food allergen. Therefore, identification of
children with a combination of food allergy and (unknown) asthma is important
to counsel parents on the risk of developing anaphylaxis.
The aim of our study is to improve our ability to interpret the laboratory
results of food sensitization in a clinical situation. This will help us in the
future to determine which children will develop food related physical
symptoms. Further, a second aim of the study is to determine the association
between peanut sensitization, peanut allergy and the severity of asthma.

- To determine the association between peanut sensitization and food related
physical symptoms
- To determine the association between peanut sensitization and the severity of
asthma in children

Prospective cohort

The parents of the participating children will fill out two validated
questionnaires. The first is regarding their child*s exposure to peanut and his
food related physical symptoms. The second is about astma related physical
symptoms. Based on the first questionnaire, we will decide if there is a
possibility of a true peanut allergy or not. In case this could be present,
they and their child (if >6 years) are invited to visit the out-patient clinic
of the Amalia pediatric department for an interview. During this interview the
child*s exposure to peanuts and it*s symptoms will be discussed in more detail.
If asthma-related symptoms excist, this will also be discussed in more detail.
Children six years of age or older will participate in a lung function test as
well.

If there still is suspicion of true peanut allergy after this interview and the
child is four years of age or older, parents will be offer for their child to
participate in a double-blind placebo-controlled food challenge to diagnose the
existence of the allergy.
This is not a component of this study, it will be regular patientcare.

A disadvantage of participation will be the time involved. The participants
and/or their parents will complete a questionnaire, and will be seen at the
pediatrics department up to 1 time. This will be an interview and a lung
function test.
However, as stated before, there will be a possibility to clarify their peanut
sensibility and possibly their asthma-related symptoms.

This study will investigate the peanut sensitization in children. We are
specifically interested in the symptoms of peanut-allergy in children. We can
not extrapolate the symptoms of adults to children.