Resolution of peanut allergy following bone marrow transplantation for primary immunodeficiency

Peanut allergy is a severe and life-threatening form of food allergy. Treatments are being developed but the mainstays of current management remain avoidance of peanut and appropriate use of rescue medication. We report the case of a boy with peanut allergy who required a bone marrow transplant (BMT) for combined immunodeficiency. A food challenge, 2 years after transplant, showed that his peanut allergy had resolved. Allergic disorders constitute a form of immune deviation and while we do not advocate BMT as a treatment for peanut allergy, we believe this case provides an insight into the basic mechanisms involved in food allergy. Copyright (C) 2005 Blackwell Publishing Ltd.; References: 1. Hourihane JO'B. Prevalence and severity of food allergy - need for control. Allergy 1998;53(Suppl. 46):84-88. 2. Grundy J, Matthews S, Bateman B, Dean T, Arshad SH. Rising prevalence of allergy to peanut in children: data from 2 sequential cohorts. J Allergy Clin Immunol 2002;110: 784-789. 3. Kagan R, Joseph L, Dufresne C, Gray-Donald K, Turnbull E, St Pierre Y et al. Prevalence of peanut allergy in primary-school children in Montreal, Canada. J Allergy Clin Immunol 2003;112: 1223-1228. 4. Agnosti JM, Sprenger JD, Lum LG, Witherspoon RP, Fisher LD, Storb R et al. Transfer of allergen-specific IgE-mediated hypersensitivity with allogeneic bone marrow transplantation. N Engl J Med 1988;319: 1623-1628. 5. Legendre C, Caillat-Zucman S, Samuel D, Morelon S, Bismuth H, Bach JF et al. Transfer of symptomatic peanut allergy to the recipient of a combined liver- and-kidney transplant. N Engl J Med 1997;337: 822-825. 6. Hourihane J, Hodges E, Smith J, Keefe M, Jones A, Connett G. Interferon-[alpha] treatment of molluscum contagiosum in immunodeficiency. Arch Dis Child 1999;80: 77-79. 7. Wahn V, Laws HJ, Bode CP, Burdach SE. Cure of latex allergy by bone marrow transplantation. Eur J Pediatr 1999;158: 88. 8. Hourihane JO'B, Roberts SA, Warner JO. Resolution of peanut allergy: case-control study. Br Med J 1998;316: 1271-1275. 9. Skolnick HS, Conover-Walker MK, Koerner CB, Sampson HA, Wood RA. The natural history of peanut allergy. J Allergy Clin Immunol 2001;107: 367-374. 10. Fleischer DM, Conover-Walker MK, Christie L, Burks AW, Wood RA. The natural progression of peanut allergy: Resolution and the possibility of recurrence. J Allergy Clin Immunol 2003;112: 183-189. 11. Gennery AR, Flood TJ, Abinun M, Cant AJ. Bone marrow transplantation does not correct the hyper IgE syndrome. Bone Marrow Transplant 2000;25: 1303-1305.