Children with peanut allergy at higher risk of allergy to other legumes: study

Legume consumption has increased during the two past decades. In France, legumes are responsible for 14.6% of food-related anaphylaxis in children, with peanuts as the main allergen (77.5%). Few studies have demonstrated cross-reactivities between peanuts and other legumes. The aim of this study was to determine prevalence and relevance of sensitization to legumes in peanut-allergic children.

All children, aged of 1–17 years, admitted to the Pediatric Allergy Department of the University Hospital of Nancy between January 1, 2017 and February 29, 2020 with a confirmed peanut allergy (PA) and a documented consumption or sensitization to at least one other legume were included. Data were retrospectively collected regarding history of consumption, skin prick tests, specific immunoglobulin E (IgE), prior allergic reactions, and oral food challenges for each legume.

Results:

• Among the 195 included children with PA, 122 were sensitized to at least one other legume (63.9%).
• Main sensitizations were for fenugreek (N = 61, 66.3%), lentil (N = 38, 42.2%), soy (N = 61, 39.9%), and lupine (N = 63, 34.2%).
• Among the 122 sensitized children, allergy to at least one legume was confirmed for 34 children (27.9%), including six children who had multiple legume allergies (4.9%). Lentil, lupine, and pea were the main responsible allergens.
• Half of allergic reactions to legumes other than peanut were severe.

Thus, the high prevalence of legume sensitization and the frequent severe reactions reported in children with PA highlight that tolerated legume consumption should be explored for each legume in the case of PA, and sensitization should be investigated if not.

Reference:

Timé Muller, et al. Relevance of sensitization to legumes in peanut-allergic children. Pediatric Allergy and Immunology. Volume 33, Issue 9 e13846. https://doi.org/10.1111/pai.13846

Keywords:

Timé Muller, Amandine Luc,Tania Adam, Sophie Jarlot-Chevaux, Pascale Dumond, Cyril Schweitzer, Françoise Codreanu-Morel, Amandine Divaret-Chauveau, Relevance, sensitization, legumes, peanut-allergic, children