Introduction of peanuts in younger siblings of children with peanut allergy: A follow-up
Monday, March 5, 2018
South Hall A2 (Convention Center)
Maxime Paquin, MD, Francois Graham, MD, Louis P. Paradis, MD FAAAAI, Jonathan Lacombe Barrios, MD, Jean Paradis, MD FAAAAI, Philippe Begin, MD, PhD, FRCPC, FAAAAI, Anne M. Des Roches, MD FAAAAI

The Finding the Risk of Anaphylaxis and Testing Rationale In youngEr Siblings (FRATRIES) study
was conceived to determine the risk of anaphylaxis, the predictive value of peanut allergy tests,
and parents’ preference in the context of peanut introduction in the younger siblings of peanut-
allergic children. The objective of this follow up was to monitor changes in the prevalence of
allergies and adherence to peanut consumption in the younger siblings of peanut-allergic


A telephone survey was performed in the whole population of younger siblings after the
supervised introduction of peanuts that took place between 2013 and 2014. Families were
asked whether peanut consumption was pursued or if an allergic reaction had occurred since
the supervised introduction. In case of peanut avoidance or a new suspected peanut allergy,
patients were invited for clinical assessment. If indicated, skin testing, specific IgE analyses as well as challenges were performed.


Of the initial cohort of 146 non-allergic children, 133 were contacted for this study (89.9%). 109
(82.0%) had introduced peanut on a regular basis against 24 (18.0%). Of these 24 children,
fifteen had never introduced peanuts, seven rarely consumed them and two stopped eating
peanuts following a suspicion of allergy. Seventeen of these patients were seen in clinic. Three
new cases of peanut allergy were diagnosed, increasing the total allergy prevalence of the
younger sibling cohort from 5.2% (8/154) to, at least, 7.1% (11/154).


Despite negative skin tests, supervised introduction at the allergy clinic and regular consumption
advice, several families had still not introduced peanut. Also, new cases of peanut allergy were
diagnosed even in regular peanut eaters.