Overview
Diagnosis
The process of diagnosing a peanut allergy begins with talking to your healthcare team about your symptoms and medical history. A physical exam usually follows, and additional steps may include:
• Food diary, to track eating habits, symptoms and medicines
• Skin test, where a small amount of food or substance is placed on the skin and pricked. A raised bump indicates an allergy
• Blood test, which measures immunoglobulin E (IgE) antibodies in the bloodstream to detect an immune response to certain foods
• Elimination diet, where suspected foods are removed from the diet and gradually reintroduced to identify triggers. This method is not used if there’s a risk of severe reactions
These methods help confirm a peanut allergy or may indicate another cause, such as food intolerance.
Treatment
The primary approach to managing peanut allergy is strict avoidance of peanuts and peanut-containing foods. Researchers continue to explore therapies to reduce the risk of severe reactions, including anaphylaxis.
Immunotherapy
Immunotherapy, also called desensitization, trains the immune system to tolerate certain triggers. It may not cure peanut allergy but can lower the risk of severe reactions.
Oral immunotherapy (OIT) involves giving gradually increasing doses of peanut-containing foods until the highest tolerated dose is reached. An FDA-approved OIT medicine, Peanut Allergen Powder-dnfp (Palforzia), is available for children ages 4 to 17 with confirmed peanut allergy. This treatment is not recommended for people with uncontrolled asthma or certain conditions like eosinophilic esophagitis.
Antibody treatments
Antibody therapy works differently from immunotherapy. These injections bind to specific proteins that trigger allergic reactions, reducing the immune system’s sensitivity. Omalizumab (Xolair) is an example used for peanut allergy.
Being prepared for a reaction
Avoiding peanuts is the only way to prevent a reaction, but accidental exposure is possible. For severe allergic reactions, emergency treatment with epinephrine is necessary. Many people carry an epinephrine autoinjector, which delivers a single dose when pressed against the thigh.
Tips for using an autoinjector:
• Carry it at all times and keep a backup in accessible places
• Replace before the expiration date
• Learn how to use it and ensure people around you know how to use it
• Use it promptly when needed, as advised by your healthcare professional
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