Jim Kling

May 26, 2015

DENVER — Many children with asthma are also allergic to peanuts, but are unaware of it, according to results from a study presented here at the American Thoracic Society 2015 International Conference.

"We wanted to get a sense of whether the peanut sensitivity rate in asthma patients could be higher than in the general population," Robert Cohn, MD, from Dayton Children's Hospital in Ohio, told Medscape Medical News.

In their pediatric pulmonary clinic, Dr Cohn and his team noticed that children with asthma often unknowingly have peanut sensitivity. And some asthma inhalers, such as Atrovent and Combivent, use soy-based lecithin, which is contraindicated for people with peanut allergy.

To understand the extent of the problem, the researchers conducted a retrospective study. Only 163 of the 1517 (10.7%) children analyzed had a known history of peanut allergy.

During the treatment period, 665 children (43.8%) underwent specific immunoglobulin E testing for peanut allergy. Of those, 148 (22.3%) tested positive for peanut allergy, 78 (52.7%) of whom were unaware they had the sensitivity.

It might be no accident that that peanut sensitivity occurs at a higher rate in people with asthma than the general population, said Dr Cohn. Repeated exposure to the soy lecithin in some inhalers could be provoking sensitivity, he suggested.

Repeat Exposure to Soy From Inhalers

"My feeling is that if you have a child with uncontrolled asthma, check to be sure there's no peanut sensitivity. It's so easy to test for," Dr Cohn said.

There is also evidence that people who die of peanut allergy have asthma as well, and many of them had poorly controlled asthma, said Sharon Dell, MD, from the University of Toronto, who attended the session.

"If you have a peanut allergy and asthma, it's very important that the asthma be well controlled," Dr Dell told Medscape Medical News. That way, in the event of "inadvertent exposure to peanuts, you can at least decrease the risk" of dying from the exposure.

She said she is intrigued by the potential relation between peanut allergy and asthma severity. "I think kids with peanut allergy and asthma probably have more severe asthma," she said, "so that would be something interesting to look at."

Dr Cohn and Dr Dell have disclosed no relevant financial relationships.

American Thoracic Society (ATS) 2015 International Conference: Abstract 61468. Presented May 17, 2015.

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