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Prevalence and characteristics of peanut allergy in US adults

  • Author Footnotes
    ∗ These authors are cofirst authors and contributed equally to this work.
    Christopher Warren
    Footnotes
    ∗ These authors are cofirst authors and contributed equally to this work.
    Affiliations
    Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Ill

    Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, Calif
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  • Author Footnotes
    ∗ These authors are cofirst authors and contributed equally to this work.
    Dawn Lei
    Footnotes
    ∗ These authors are cofirst authors and contributed equally to this work.
    Affiliations
    Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill

    Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
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  • Scott Sicherer
    Affiliations
    Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY
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  • Robert Schleimer
    Affiliations
    Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill
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  • Ruchi Gupta
    Correspondence
    Corresponding author: Ruchi S. Gupta, MD, 750 N Lake Shore Drive, Suite 680 Chicago, IL 60611.
    Affiliations
    Center for Food Allergy and Asthma Research, Northwestern University Feinberg School of Medicine, Chicago, Ill

    Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
    Search for articles by this author
  • Author Footnotes
    ∗ These authors are cofirst authors and contributed equally to this work.
Published:February 09, 2021DOI:https://doi.org/10.1016/j.jaci.2020.11.046

      Background

      Peanut allergy (PA) is the leading pediatric food allergy and a common cause of anaphylaxis. Little is known, however, on the prevalence and characteristics of PA in the adult population and whether phenotypic differences exist between adult-onset and childhood-onset PA.

      Objectives

      This study describes the current US population-level burden of adult PA.

      Methods

      A cross-sectional food allergy survey was administered via phone and web in 2015 and 2016, resulting in nationally representative complex-survey weighted data for 40,443 adults. Reported food allergies were considered “convincing” if symptoms to specific allergens were consistent with an IgE-mediated reaction.

      Results

      The prevalence of current self-reported PA was 2.9% among US adults, with 1.8% having convincing PA. Over 17% of adults with peanut allergy reported onset of their PA in adulthood. In adults with childhood-onset PA, 75.4% reported physician-diagnosed PA, compared with only 58.9% of adult-onset PA. Despite a similar frequency of food allergy–related emergency department visits within the past year (approximately 1 in 5 adults with PA allergy), adults with childhood-onset PA were significantly more likely to have a current epinephrine prescription compared with those with adult-onset PA (56% vs 44% respectively; P = .02) and were more likely to use an epinephrine autoinjector (48% vs 35%, P = .01).

      Conclusions

      Approximately 4.6 million US adults have PA—over 800,000 of whom appear to have developed their PA after age 18 years. Further examination of phenotypic differences between childhood-onset and adult-onset PA may improve understanding and management of adult PA.

      Key words

      Abbreviations used:

      EAI (Epinephrine autoinjector), ED (Emergency department), OAS (Oral allergy syndrome), PA (Peanut allergy), sIgE (Specific IgE), SPT (Skin prick test)
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