Diagnostics of peanut allergy – part I

The correct determination of the diagnosis of peanut allergy is important to protect the patient from the the occurrence of an anaphylactic reaction, as well as avoiding an unnecessary elimination diet. The basis of diagnosis of peanut allergy is a history focused on symptoms associated with the consumption of these products. Another part of the diagnosis is the assessment of sensitization through the evaluation of skin prick test and/or sIgE with peanut extract. It is useful to know the cutoff points to decide whether to qualify a child for an oral food challenge by assessing the positive and negative predictive value of the result. A valuable complement to the diagnosis of peanut allergy is component-resolved diagnostics. Studies indicate that component-resolved diagnostics is superior to skin prick test and sIgE in the diagnosis of peanut allergy. It is currently recognized that sensitization to Ara h 2 is the factor best identifying patients with peanut allergy. Definitive establishment of the diagnosis of peanut allergy requires a combined analysis of patients’ history and sensitization status and possible qualification for an oral food challenge.