According to new research, peanut tolerance in
siblings could be predicted by a negative test
result prior to introduction.

A Canadian study
published in the June 2016  
found that siblings whose peanut allergy tests
were negative prior to introduction did not have
an allergic response when they ate peanut for the
first time. The study included 154 younger
siblings of peanut allergic children. The
participants had never eaten peanut and ranged
in age from under 12 months to over 5 years, with
a median age of 23 months.

Performed Tests
Double-blinded skin prick tests were performed
with peanut extract and peanut butter and blood
samples were collected for peanut-specific IgE
analysis then parents fed peanut products to all
the children under medical supervision.

Eight siblings experienced allergic reactions in
response to peanut introduction. Of these, five
needed to be given epinephrine and one child
required two epinephrine injections and was later
hospitalized. All of the eight reactive children  
had either skin test reactivity to peanut or high
concentrations of peanut-specific IgE antibodies
prior to eating peanut.

There is an increased risk of anaphylaxis upon
peanut introduction in siblings of children with
peanut allergy. Most parents are reluctant to give
peanuts to the younger sibling at home without
testing. The good news is that allergy testing
prior to introduction was negative in over 90% of
cases which according to the researchers it carries
a high negative predictive value.

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