Reference : Peanut-allergic patients in the MIRABEL survey: characteristics, allergists' dietary ...
Scientific journals : Article
Human health sciences : Multidisciplinary, general & others
Human health sciences : Endocrinology, metabolism & nutrition
Peanut-allergic patients in the MIRABEL survey: characteristics, allergists' dietary advice and lessons from real life
Deschildre, A []
Elegbédé, CF []
Just, J []
Bruyère, Olivier mailto [Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé >]
Van der Brempt, X []
Papadopoulos, A []
Beaudouin, E []
Renaudin, JM []
Crepet, A []
Moneret-Vautrin, DA []
Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Blackwell Publishing
Yes (verified by ORBi)
United Kingdom
[en] diet ; peanut allergy ; real life ; risk factor ; severe reactions
[en] Background The MIRABEL survey is an observational study on peanut allergy in France,
Belgium and Luxemburg. The objectives are to provide data on a large population, to
analyse the consumer behaviour, to study the presence of peanut traces in pre-packed
foods with/without precautionary allergen labelling (PAL), and to combine these data to
quantify allergic risk and produce a cost/benefit analysis. This paper reports a real-life
observatory of 785 patients (< 16y: 86%): medical characteristics, eliciting doses (ED) in
real life and in oral food challenges (OFC), factors associated with severe reactions, allergist
dietary advice and patients’ anxiety regarding their allergy.
Methods Age and symptoms at diagnosis, route of exposure, comorbidities, allergy tests,
ED (OFC/real life; mg peanut protein), dietary advice about PAL, and anxiety score were
Results Median age was 3 years; 85% were declared allergic. Severe/potentially severe
reactions were reported in 30% of the allergic patients: serious systemic reaction (15%),
laryngeal angioedema (8%), shock (4%) and acute asthma (3%); 66% had atopic dermatitis,
58% asthma. Median ara h 2 sIgE level was 11.5 kUA/L. Of the 278 OFCs, 225 were
positive (median ED: 67.3 mg). Real-life ED was < 100 mg in 44.3%. Severe reactions
were significantly more frequent in teenagers and adults (P = 0.004), asthmatic patients
(P = 0.033), and patients who reacted to inhalation (P < 0.001). No significant association
was found for OFC ED or ara h 2 sIgE. Factors associated with strict avoidance advice
including PAL were OFC ED < 100 mg (P < 0.001), but not severe reaction history
(P = 0.051) or asthma (P = 0.34). Anxiety was significantly associated with strict avoidance
(P < 0.001).
Conclusion and clinical relevance Severe/potentially severe reactions, allergic comorbidities,
and low EDs in real life are frequent in peanut-allergic patients. Asthma, teenage/
adulthood and reaction to inhalation are associated with severe symptoms. PAL and criteria
guiding dietary advice need to be improved.

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