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Peanut allergy: Burden of illness

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Peanut allergy affects 1% to 4.5% of children, with the potential for severe reactions. The peanut allergy burden impacts families, communities, and societies.


To provide an update on the peanut allergy burden of illness and diagnostic pitfalls.


A narrative review of the literature that described the role of food allergy testing for the evaluation of clinical allergy or eczema, consequences of peanut allergy diagnosis, quality of life, and emerging peanut immunotherapies.


Peanut allergy is considered persistent in the majority of those diagnosed with it; however, fatal anaphylaxis is rare. There is an absence of evidence to support food allergy screening in children with eczema, apart from those with immediate food reactions. Allergist-directed education may enhance the quality of life for patients and families living with peanut allergy. Appropriate pricing, availability, and use of epinephrine autoinjectors may reduce peanut allergy burden of illness. Peanut oral immunotherapy may decrease anxiety but, on balance, may cause more episodes of peanut anaphylaxis than it prevents.


The personal, family, community, and societal burden of peanut allergy is significant but can be reduced by preventing overdiagnosis. Patient education should be anchored in the appropriate risk perspective. Longer-term data are needed to better understand how peanut immunotherapy products can be leveraged to improve patients' quality of life.
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Keywords: Peanut allergy; asthma; atopic dermatitis; cost-effectiveness; eczema; epinephrine; fatality; food allergy; overdiagnosis; peanut sensitization; quality of life (QoL); screening; tolerance; value-based price

Document Type: Research Article

Affiliations: 1: From the Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 2: Section of Allergy and Immunology, Food Challenge and Research Unit, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado

Publication date: September 1, 2019

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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