{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:17:17Z","timestamp":1780503437948,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,7,11]],"date-time":"2016-07-11T00:00:00Z","timestamp":1468195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008154","name":"Canadian Allergy, Asthma and Immunology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008154","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prevalence of peanut allergy in younger siblings of children with peanut allergy has been reported between 7% and 8.5%, but the anaphylactic risk at the time of introduction is currently unknown, which limits our ability to best counsel parents on this issue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the risk of anaphylaxis and working parameters of allergy testing in this context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and fifty\u2010four peanut\u2010na\u00efve younger siblings of peanut\u2010allergic children underwent double\u2010blinded skin testing, followed by parent\u2010led peanut introduction. Questionnaires were dispensed to parents to investigate preferences with regard to peanut introduction in this subgroup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight participants (5.2%) presented unequivocal IgE\u2010mediated reactions to peanut upon introduction, including five anaphylaxes. These participants were significantly older compared to the rest of the cohort (median 4.0 <jats:italic>vs<\/jats:italic> 1.9\u00a0years, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.04). The negative predictive value of skin prick test with peanut extract and peanut butter and of specific IgE was 99%, 100%, and 100%, respectively. Six peanut\u2010tolerant participants had positive peanut allergy tests. The option of introducing at home without prior skin testing was associated with high levels of anxiety (median 8.4 on 10\u2010point Likert scale) when compared to supervised introduction (median 3.8, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) or home introduction after negative skin test (median 4.3, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is an increased risk of anaphylaxis upon peanut introduction in siblings of children with peanut allergy, and parents are reluctant to introduce at home without testing. Allergy testing prior to introduction is negative in over 90% of cases and carries a high negative predictive value.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.12956","type":"journal-article","created":{"date-parts":[[2016,6,13]],"date-time":"2016-06-13T11:47:46Z","timestamp":1465818466000},"page":"1762-1771","source":"Crossref","is-referenced-by-count":26,"title":["Introduction of peanuts in younger siblings of children with peanut allergy: a prospective, double\u2010blinded assessment of risk, of diagnostic tests, and an analysis of patient preferences"],"prefix":"10.1111","volume":"71","author":[{"given":"P.","family":"B\u00e9gin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Service of Allergy and Clinical Immunology Centre Hospitalier Universitaire Sainte\u2010Justine Montreal QC Canada"},{"name":"Department of Medicine, Service of Allergy and Clinical Immunology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al Montreal QC 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