IGHE and peanut allergic reaction: Before tocilizumab treatment, oral food challenges were not performed due to the severity of previous reactions and ethical considerations. The patient's total serum IgE level at initial presentation was 358 kU/L (reference range: < 57 kU/L). While it is acknowledged that egg and milk allergies often resolve spontaneously in young children, the patient's peanut allergy was considered persistent based on the severity of reactions and consistently high sIgE levels.