Diagnostics of peanut allergy – part II

The basophil activation test is increasingly being used to complement the diagnosis of peanut allergy. It is a test characterized by very high sensitivity, specificity and safety. The greatest benefits of performing basophil activation test occur in patients with unclear medical history, lack of information in the history of oral exposure to the allergen and questionable results of previously performed tests. The current gold standard for diagnosing peanut allergy is the oral food challenge. In the case of peanuts, it is associated with a high risk of severe allergic reactions, therefore, it should be performed in centers specializing in food allergy. In qualifying for an oral food challenge should take into account, among other things, data from the history and results of tests for sensitization, including assessment of Ara h 2. The criteria for discontinuation of oral food challange and interpretation of its result are defined in detail, which facilitates daily medical practice. In the future, great benefits are indicated of performing epitope diagnostics, which makes it possible to distinguish between different allergy phenotypes, but is currently only available during clinical trials.