Adult-Onset Peanut Allergy: What Are the Characteristics?

Adult-onset peanut allergy (PA) may be more common and difficult to treat than previously thought, according to the results of a recent study.

In order to examine the burden of adult-onset PA in comparison to childhood-onset PA, the researchers conducted a population-based, cross-section survey within the United States. The survey was conducted via phone and web from October 2015 to September 2016.

Included were 40,443 adults who reported on their food allergies. To be considered “convincing,” food allergy symptoms to specific allergens had to be consistent with an IgE-mediated reaction.

The results indicated that 2.9% of US adults self-reported a peanut allergy, with 1.8% having convincing peanut allergy. The onset of this allergy occurred in adulthood for 17.5% of adults with peanut allergy. This allergy was physician-diagnosed in only 58.9% of adult-onset peanut allergy cases, whereas in adults with childhood-onset peanut allergy 75.4% were diagnosed by a physician.

In addition, 56% of adults with childhood-onset PA had a current epinephrine, whereas only 44% those with adult-onset PA had a current prescription. Childhood-onset PA patients were more likely to use an epinephrine autoinjector (48%) than adult-onset PA patients (35%). These comparisons come despite the two groups having a similar frequency of food allergy-related emergency department visits within the past year of approximately 1 in 5 adults with a PA allergy.

“In sum, these data indicate that substantially more US adults are affected by PA than previously acknowledged, and there are important phenotypic differences between patients with childhood-onset versus those with adult-onset PA. Additional work is needed to further contextualize these differences and translate these findings into improved food allergy diagnosis, management, and treatment,” the researchers concluded.

—Leigh Precopio

Reference:

Warren C, Lei D, Sicherer S, Schleimer R, Gupta R. Prevalence and characteristics of peanut allergy in US adults. J Allergy Clin Immunol. Published online February 9, 2021. https://www.jacionline.org/article/S0091-6749(20)32412-X/fulltext