Transfer of peanut allergy through PBSCT

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Unknown; not uncommon
Time to detection: 
32 days post transplantation, unrelated donor
Alerting signals, symptoms, evidence of occurrence: 
First episode (day +32) of angioedema with swelling of the nasal and oral mucosa 30 min after consuming peanut puffs. Second episode eight months after PBSCT, angioedema, generalized pruritus and nausea within minutes after eating biscuits containing hazelnut and peanut. Topical application of a peanut oil-containing ointment, resulted in facial erythema and angioedema.
Demonstration of imputability or root cause: 
Nine months after PBSCT evaluation for peanut allergy: highly increased specific IgE to peanut. Accordingly, skin prick tests for peanut extract were also positive. The stem cell donor confirmed intolerance to peanuts. His specific serum IgE pattern nine month after PBSCT harvest was analysed and showed similar sensitization profiles compared to those of the transplant recipient.
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
food allergy
peanut allergy
Suggest references: 
A Lurking Threat: Transfer of Peanut Allergy Through Peripheral Blood Stem Cell Transplantation. Brauns et al, World Allergy Organ J. 2016 Feb 8;9:3
Expert comments for publication: 
This paper shows the importance of knowing specific donor allergies, if they can have far-reaching consequences for the recipient of the stem cells. Recipients need to be counseled and aware of potential dietary restrictions post HSCT, if a donor has a serious allergy to a specific food.