A new study has revealed that many young asthma patients are sensitive to peanuts but don’t know it.<
The discovery has prompted researchers to advise parents that children with asthma should be tested for peanut allergies. They also note that children with peanut allergies should not be treated with some asthma medicines.
Dr. Robert Cohn, the lead author of the study, said that many symptoms of peanut allergies and asthma attacks are similar. These symptoms include wheezing, coughing, and shortness of breath.
Cohn’s study will be presented at the American Thoracic Society (ATS) 2015 International Conference, which runs through May 20.
Looking at the Research
As part of the study, researchers looked at data from 1,517 children at Mercy Children's Hospital in Toledo, Ohio. The children were in the pediatric pulmonary clinic.
The researchers studied the children’s charts to see if they had a peanut allergy and if they had had a blood test for immunoglobulin E (IgE) antibodies. If children have a documented history of peanut allergy and high levels of IgE, they are considered to have a peanut allergy. Children who tested positive but did not report a peanut allergy prior to testing were labeled as “unsuspected.”
As part of the review, the researchers found that 11 percent of children had a history of peanut allergy. About 44 percent had been tested for IgE. Of them, 22 percent had high levels and 53 percent of the children and their families did not suspect peanut sensitivity.
The occurrence of positive tests differed across age groups, but the prevalence of known peanut allergy was similar across those groups.
“This study demonstrates that children with asthma might benefit from a test for peanut sensitivity, especially when control of wheezing and coughing is difficult to achieve,” Cohn said.
When Should a Child Be Tested?
Cohn advises that parents and physicians who notice symptoms of peanut allergy should consider testing children if they cannot control coughing or wheezing. This goes for parents who do not think their children have a peanut sensitivity.
“I don’t think children with peanut allergies would be misdiagnosed with asthma. It is most likely the other way around. Children with asthma might not be recognized as having a peanut sensitivity,” Cohn said.
He said that parents whose children have asthma should understand that some asthma medicines may not be advisable in children with peanut allergies.
“Since any allergy can act as a trigger for an asthma attack, it might be helpful to have the child screened for a peanut sensitivity if they have been diagnosed with asthma,” he said.
Cohn said it’s possible a peanut allergy or anaphylactic reaction could be misdiagnosed as an asthma attack. Peanut allergic reactions tend to be more serious than asthma attacks and might not respond to asthma rescue inhalers, he noted.
Epinephrine pens are commonly prescribed to children with peanut allergies because those reactions can be life-threatening.
Another expert urges a little more caution.
"It is not surprising that children with asthma have a high rate of peanut sensitivity," said Dr. Jacob Kattan, an assistant professor at the Pediatric Allergy and Clinical Immunology Icahn School of Medicine at Mount Sinai. "I would, however, advise against testing all children with asthma for peanut allergy."
Kattan said that current peanut testing allergies are accurate, but test results can be positive among children without allergies. Unnecessary testing can lead to unwarranted dietary restrictions and stress for patients and their families, in addition to increased health care costs, Kattan said.
"Typically, we don’t test for a food allergy when a child is regularly eating a food without any apparent allergic symptoms, which we usually expect to occur within two hours of eating the offending food.," Kattan said.
He said it can be a good idea to pursue an evaluation with a doctor, but he doesn't recommend widespread food allergy testing by physicians without extensive experience in the management of food allergies.