{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T04:38:17Z","timestamp":1771648697992,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,21]],"date-time":"2021-03-21T00:00:00Z","timestamp":1616284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010665","name":"H2020 Marie Sk\u0142odowska-Curie Actions","doi-asserted-by":"publisher","award":["656878"],"award-info":[{"award-number":["656878"]}],"id":[{"id":"10.13039\/100010665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/K010468\/1"],"award-info":[{"award-number":["MR\/K010468\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000354","name":"Food Standards Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000354","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Clinical reactions to Oral Food Challenge (OFC) in peanut\u2010allergic individuals have been well\u2010characterised, but rates and phenotypes of symptom recurrence beyond the first hour after objective symptoms are less well\u2010characterised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the rate of new\u2010onset symptoms occurring at least 1\u00a0h after stopping OFC in peanut\u2010allergic children and adults undergoing peanut\u2010OFC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively collected data relating to adverse events following positive reactions at double\u2010blind, placebo\u2010controlled food challenges (DBPCFC) to peanut in children and adults evaluated for eligibility to participate in two clinical trials (NCT02149719, NCT02665793). The trials included people aged 8 to 45 with primary, IgE\u2010mediated peanut allergy at DBPCFC. The challenge protocol included consumption of a light meal 1\u00a0h after reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 121 participants (64 children, 57 adults) had immediate, objective symptoms at DBPCFC, 25 (17 children, 8 adults) with anaphylaxis. Thirty\u2010three (27%) had progression or recurrence of symptoms \u2265\u00a01 h after objective clinical reaction, of whom 8 developed anaphylaxis. In 23 cases, the onset of new symptoms was associated with consumption of a light meal. In eight cases, symptoms were limited to a symptomatic postural fall in blood pressure noted in preparation for discharge, without any other new features of an allergic reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Clinical Relevance<\/jats:title><jats:p>Progressive or new\u2010onset symptoms \u22651\u00a0h following initial allergic reaction at OFC are common and can include orthostatic hypotension. Recurrent symptoms may be temporally associated with food consumption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13865","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T05:55:28Z","timestamp":1615701328000},"page":"696-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Delayed symptoms and orthostatic intolerance following peanut challenge"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9862-5161","authenticated-orcid":false,"given":"Paul J.","family":"Turner","sequence":"first","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Ruiz\u2010Garcia","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nandinee","family":"Patel","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gon\u00e7alo","family":"Abrantes","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Burrell","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Vazquez\u2010Ortiz","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3629-4293","authenticated-orcid":false,"given":"Isabel","family":"Skypala","sequence":"additional","affiliation":[{"name":"Royal Brompton and Harefield Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen R.","family":"Durham","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"},{"name":"Royal Brompton and Harefield Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-7580","authenticated-orcid":false,"given":"Robert J.","family":"Boyle","sequence":"additional","affiliation":[{"name":"National Heart &amp; Lung Institute Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.10.017"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(94)70044-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.12.1303"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2014.12.010"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2013.34.3669"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.10.006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-017-0215-8"},{"key":"e_1_2_8_9_1","first-page":"2020","article-title":"Self\u2010administration of adrenaline for anaphylaxis during in\u2010hospital food challenges improves health\u2010related quality of life","volume":"18","author":"Burrell S","year":"2020","journal-title":"Arch Dis Child"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2019.06.038"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13442"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02715.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2020.100472"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.1084"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iac.2007.03.003"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.04.014"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1614"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/cea.12748"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2020.06.033"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000093388.17298.90"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-15-S3-S2"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2014.127"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1109\/JBHI.2013.2290706"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.03.035"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12576-017-0527-y"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00193.2018"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2010.519823"}],"container-title":["Clinical &amp; 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