These are exciting times for the treatment of peanut and tree nut allergies in children. Protocols that aim to desensitize patients to foods have moved from being experimental to being available to patients across the country.
In 2018, Oregon Allergy Associates performed desensitization for roughly 35 peanut- and tree nut-allergic patients. Results were highly successful with no patients dropping out prematurely and all patients either reaching a maintenance dose or still building toward it.
In a “nutshell,” desensitization patients are exposed to very small doses of their allergenic food, which build over time. Normally, patients will build to 1-2g of daily exposure over the course of 6-12 weeks. Symptoms during buildup are generally expected but are mild in the majority of cases. Itching of the mouth and throat are common. Vomiting can occur in some cases and is treated with antacids and antihistamine. Breathing trouble or more serious symptoms are treated with an Epi-pen. Of our 35 patients, only one has required an Epi-pen during treatment.
The aim of oral immunotherapy is to reduce the risk of symptoms with accidental exposure. Patients do not typically add the allergenic nut to their diet other than their daily, supervised dose at home. As an example, an accidental exposure to a peanut butter granola bar resulted in an itchy mouth; epinephrine or a visit to the ER was not necessary.
If you have questions or think your child might be a good candidate for oral immunotherapy, please contact our oral immunotherapy nurses. They would be happy to schedule an appointment to discuss the possibility. FAQs are also available, upon request.