{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:02:12Z","timestamp":1791039732162,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T00:00:00Z","timestamp":1537142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003842","name":"Ilhan Food Allergy Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003842","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Peanut allergy is classically managed by food avoidance. Immunotherapy programs are available at some academic centers for selected patients reacting to small amounts of peanut during food challenge. We aimed to determine and compare reaction thresholds and prevalence of anaphylaxis during peanut oral challenges at multiple specialist allergy centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, international survey of anonymized case records from seven specialist pediatric allergy centers from the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> and Ireland, as well as the Australian HealthNuts study. Demographic information, allergy test results, reaction severity and threshold during open oral peanut challenges were collated and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1634 children aged 1\u201018\u00a0years old included, 525 (32%) failed their peanut challenge. Twenty\u2010eight percent reacted to 25\u00a0mg, while 38% only reacted after consuming 1\u00a0g or more of whole peanut. Anaphylaxis (55 [11%]) was 3 times more common in teenagers than younger children and the likelihood increased at all ages as children consuming more peanut at the challenge. Children who developed anaphylaxis to 25\u2010200\u00a0mg of whole peanut were significantly older. Previous history of reaction did not predict reaction threshold or severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>More than a third of the children in this large international cohort tolerated the equivalent of one peanut in an oral challenge. Anaphylaxis, particularly to small amounts of peanut, was more common in older children. Tailored immunotherapy programs might be considered not only for children with low, but also higher reaction thresholds. Whether these programs could prevent heightened sensitivity and anaphylaxis to peanut with age also deserves further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pai.12959","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T09:34:58Z","timestamp":1531992898000},"page":"754-761","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Severity and threshold of peanut reactivity during hospital\u2010based open oral food challenges: An international multicenter survey"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7411-5375","authenticated-orcid":false,"given":"Peter D.","family":"Arkwright","sequence":"first","affiliation":[{"name":"Royal Manchester Children's Hospital University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne","family":"MacMahon","sequence":"additional","affiliation":[{"name":"University College  Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Koplin","sequence":"additional","affiliation":[{"name":"Murdoch Children's Research Institute Royal Children's Hospital  Melbourne Vic. 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