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Sesame Allergy in Children: New Insights in Diagnosis and Management
  • MD, MSc Sarah Saf,
  • Magnus Borres,
  • Eva Södergren
MD, MSc Sarah Saf
Department of Paediatric Allergology, Armand Trousseau University Hospital, Groupe Hospitalier Universitaire, AP-HP Sorbonne-Université, Paris, France.

Corresponding Author:[email protected]

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Magnus Borres
Thermo Fisher Scientific ImmunoDiagnostics Division
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Eva Södergren
Thermo Fisher Scientific ImmunoDiagnostics Division
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Sesame is a potentially potent allergen that can trigger skin, gastrointestinal, and respiratory tract symptoms, and anaphylaxis. Only 20% to 30% of sesame-allergic children develop tolerance. The prevalence of sesame allergy depends on local diets and ranges from 0.1% to 0.9%. A high risk of accidental exposure to sesame has resulted in mandatory food labeling in many countries. More than half of patients with sesame allergy are also allergic to peanut/tree nuts. Serum specific IgE testing with a quantitative Ses i 1 component can be performed safely and has higher clinical specificity and better positive predictive value for oral food challenge (OFC) than whole sesame extract or skin prick testing (SPT). Compared with SPT or OFC, in vitro Ses i 1 testing requires no special techniques and carries no risk of reactions. Diagnosis of suspected sesame allergy begins with a thorough history and physical examination. A positive sesame extract test (≥0.1 kU A/L) should prompt further testing. In patients with a high probability of reacting, results of component testing may facilitate a decision about performing an OFC. In a Japanese study of OFC and Ses i 1, there was a 5% probability of a positive OFC with Ses i 1 sIgE levels <0.13 kU A/L, and a 50% probability of a positive OFC with levels >32.0 kU A/L. Most patients could safely consume sesame if sIgE levels were <0.13 kU A/L. Ses i 1 testing can be used to guide appropriate management (avoidance, emergency medication, and oral immunotherapy).
27 Dec 2022Submitted to Pediatric Allergy and Immunology
13 Jan 2023Submission Checks Completed
13 Jan 2023Assigned to Editor
13 Jan 2023Review(s) Completed, Editorial Evaluation Pending
26 Jan 2023Reviewer(s) Assigned
20 Feb 2023Editorial Decision: Revise Major
21 Apr 20231st Revision Received
04 May 2023Submission Checks Completed
04 May 2023Assigned to Editor
04 May 2023Review(s) Completed, Editorial Evaluation Pending
13 May 2023Reviewer(s) Assigned
31 May 2023Editorial Decision: Revise Minor
03 Jul 20232nd Revision Received
03 Jul 2023Submission Checks Completed
03 Jul 2023Assigned to Editor
03 Jul 2023Review(s) Completed, Editorial Evaluation Pending
10 Jul 2023Editorial Decision: Accept