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Meet Tim

Tim, a 6-year-old with a presumed history of peanut allergy, goes to see his healthcare professional because he’s never been tested for allergic sensitization.

Tim’s healthcare professional conducts a full clinical history and physical examination and decides to test using whole peanut allergen sIgE with reflex to components.

Patient history

Family history

  • No

Personal history

  • Tim experienced itching and tingling of the mouth and lips after eating a granola bar at age 5
  • Tim's parents assumed that reaction was due to peanut allergy
  • His previous healthcare professional recommended strict peanut avoidance

Test results

These results, together with this patient's case history and symptoms, help confirm the diagnosis.  

ImmunoCAPTM results (kUA /l)
Test Type Results
Peanut Whole Allergen 1.6
Ara h 1 Allergen Component <0.1
Ara h 2 Allergen Component <0.1
Ara h 3 Allergen Component <0.1
Ara h 8 Allergen Component 2.79
Ara h 9 Allergen Component <0.1

Differential Diagnosis

Tim's sensitization to Ara h 8 is associated with localized reactions, like itching and tingling of the mouth and lips, but low risk of systemic reaction. Tim may actually be sensitized to birch pollen, which is cross-reactive and responds similar to Ara h 8. Tim shows no detectable sensitization to three nut storage proteins associated with severe reactions.1-4

Refined diagnosis

  • Possible birch pollen allergy

Healthcare professional's management plan

  • Tim's healthcare professional advises that an oral challenge with peanut might reduce the fear of severe reactions based on his history

  • Tim passes the peanut oral food challenge without any symptoms

Follow Up

Tim has had no further issues and is doing well.

The people, places and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.

References
  1. Asarnoj A, Nilsson C, Lidholm J, et al. Peanut component Ara h 8 sensitization and tolerance to peanut. J Allergy Clin Immunol. 2012;130(2):468-472

  2. Peeters KA, Koppelman SJ, van Hoffen E, et al. Does skin prick test reactivity to purifed allergens correlate with clinical severity of peanut allergy? Clin Exp Allergy. 2007;37(1):108-115.

  3. Asarnoj A, Movérare R, Östblom E, et al. IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds. Allergy. 2010;65(9):1189-1195.

  4. Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, et al. EAACI Molecular Allergology User’s Guide. Pediatr Allergy Immunol. 2016;27 Suppl 23:1-250.