METHODS: IRB approved retrospective chart review of patients seen in our Allergy/Immunology office. Patients with ICD 9/10 diagnostic codes related to OAS over the last seven years were identified. Patients with a diagnosis of OAS, and documentation of aeroallergen IgE sensitivity were included. Patients with a history of systemic reaction or anaphylaxis, and the need for EAI for an alternative reason were excluded.
RESULTS: Fifty patients were identified. The average age was 29 years (range 6-71) and 68% were female. EAI was prescribed to 5 of 29 (17%) patients with history of reaction to fruits/vegetables and 14 of 21 (66%) patients who had reacted to tree nuts or peanuts. Three of 5 (60%) patients in the fruit/vegetable group and 11 of the 14 (79%) patients in the tree nut/peanut group had positive skin-prick testing to one of their food allergens. Nineteen patients were seen for follow up visits and no patients from either group who were prescribed EAI required its use.
CONCLUSIONS: Our data suggests that EAI are prescribed more frequently in patients with a history of OAS to tree nuts and peanuts compared to fruits/vegetables. There was no increased incidence of systemic symptoms or anaphylaxis, questioning the need for prescribing EAI in OAS. Larger studies are needed to further evaluate this patient population.