Peanut allergy.

Peanut allergy. Peanut allergy, which is frequent in the United States and was much less so in Europe up to the mid-eighties, has become a major problem in many indus trialized countries. Peanut consumption is high in Eastern Europe, the Unit ed Kingdom, The Netherlands, Germany and France. The frequency of peanut al lergy is between 0.5 and 0.7% in the general population. Two million Americ ans are now thought to be affected. In France peanuts are one of the most f requent allergens, lying second (27.4%) to egg in food allergies in childre n, and holding first place in food allergies in children aged over 3 years. Sensitization occurs through ingestion, contact even if indirect, and inha lation. The symptoms, which affect the skin and the respiratory or gastroin testinal tract, appear a few minutes to a few hours after exposure. Serious reactions (anaphylactic shock, life-threatening reactions, sudden death) h ave been described. Asthma has a significantly higher association with pean ut allergy than with other allergies, taken overall. As with other food all ergies, diagnosis is based on history, prick-tests, screening for specific serum IgE and food challenge whose modalities (labial and oral challenge) a re debated. For the time being, elimination is the only form of treatment. The development of a modified allergen as immunogenic as possible but pract ically without allergenic effects should give immunotherapy new impetus. Pa tients with severe peanut allergy should carry a card or wear a distinctive bracelet indicating their condition as well as an emergency kit including in particular epinephrine. ((C)) 2001 Editions scientifiques et medicales E lsevier SAS.