TOPLINE:

By age 15 years, roughly 20%-33% of children with nonpriority legume (NPL) allergies achieved tolerance; smaller skin prick test (SPT) wheal sizes and lower specific immunoglobulin (Ig)E levels were associated with a greater likelihood of outgrowing these allergies.

METHODOLOGY:

• Researchers conducted a retrospective review of medical records at Evelina London Children’s Hospital, London, England, from July 2023 to June 2024 to determine how often children in the UK outgrow NPL allergies and which factors predict recovery.
• They analyzed records of 203 children with IgE-mediated allergy to NPLs (median age, 10 years; 62.6% boys), confirmed through an SPT wheal size ≥ 8 mm, a specific IgE level ≥ 15 kUA/L, or a positive oral food challenge (OFC) result.
• The primary outcome was allergy resolution — defined as either a negative OFC result or demonstrated tolerance to NPLs, including lentils, chickpeas, peas, and beans, without allergic reactions.

TAKEAWAY:

• Among all children, lentil allergy was most prevalent (68.5%), followed by pea (41.4%), chickpea (40.9%), and bean (22.7%) allergies. Resolution rates by age 15 years were highest for beans (32.9%), followed by peas (23.5%), lentils (21.0%), and chickpeas (19.3%).
• A smaller SPT wheal size or lower specific IgE levels were predictors of the resolution of NPL allergies.
• Allergic reactions experienced by children were erythematous rash or itching (31%), hives (15.8%), angioedema (12.8%), vomiting (8.9%), throat itching (3%), cough (1%), and anaphylaxis (6.9%); 20.7% of children experienced multiple symptoms.

IN PRACTICE:

“It is essential to consider a broader range of factors within the patient’s clinical context, such as age, time since last reaction, and importance of the food in the child’s diet, before deciding to conduct an OFC,” the authors of the study wrote.

SOURCE:

The study, led by Ali Atwah, corresponding author of the study, King Abdulaziz University, Rabigh, Saudi Arabia, was published online on December 22 in Pediatric Allergy and Immunology.

LIMITATIONS:

The study was limited by its retrospective design, enrollment from a specialty center, and the fact that some NPL diagnoses were based on parent-reported reactions rather than OFC confirmation. Additionally, the absence of a standardized definition of tolerance and the inconsistent recording of how often and how much children consumed legumes may have affected the assessment of allergy resolution.

DISCLOSURES:

The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.