Improving diagnostics and quality of life in children with peanut allergy and other atopic diseases

Peanut allergy disrupts the daily lives of children and their parents. Families with a peanut allergic child often live with increased stress, anxiety and constant vigilance about food consumption. The aim of this thesis was to improve the diagnostics and quality of life in children with peanut allergy and their parents.

Peanut allergy diagnostics can be improved using a blood test (sIgE to peanut protein Ara h 2). In current clinical practice, patients with a suspected peanut allergy undergo a two-day food challenge to confirm or exclude a peanut allergy which is burdensome and costly. Results from this thesis indicate that children with a very low blood test result (20% of all children) can safely introduce peanut at home, without food-challenge in hospital. In children with a high blood test result (35% of all children), the two-day food challenge can be replaced by a one-day food challenge to confirm peanut allergy.

This thesis indicates that quality of life improves after a food challenge. Anxiety decreases in parents of children with a suspected peanut allergy with a very low blood test result. These results indicate that families benefit form clear peanut allergy diagnostics.

We recommend to use the blood test as described in this thesis in all children with a suspected peanut allergy in the Netherlands. This could lead to a cost reduction of up to 1.5 million euros per year.