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Title

Managing Nut Allergy: A Remaining Clinical Challenge

Authors
Lack, Gideon
Mazon, Angel
Nieto, Antonio
Haddad, Diab
Brough, Helen A
Published in Journal of Allergy and Clinical Immunology: In Practice. 2017, vol. 5, no. 2, p. 296-300
Abstract Peanut and tree nut allergies have become a public health problem over the last 2 decades. The diagnostic procedure relies on a suggestive history, as well as on evidence of sensitization (skin prick testing and/or specific IgE blood testing), followed in selected cases by a food challenge. Standard IgE tests may be positive to more than 1 nut, due to cross-reactivity (allergens common to several nuts) or cosensitivity (frequently associated positive test results without cross-reactivity). Thus, many patients with a peanut or a tree nut allergy avoid all nuts, relying on positive test results without clinical evidence of reactivity. In addition, coexisting pollen sensitivity may add to diagnostic uncertainty due to potential cross-reactivity between pollens and nuts. In this article, we discuss challenges in diagnosis and clinical management of peanut and tree nut allergy related to cross-reactivity and cosensitization, as well as the avoidance of nuts tested positive to reduce the risk of reactions by cross-contamination. Studies to provide more accurate characterization of genuine clinically relevant cross-reactivity or cosensitivity to multiple nuts are needed.
Identifiers
PMID: 27793601
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Research group Pathogenèse et traitement des allergies alimentaires (191)
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EIGENMANN, Philippe et al. Managing Nut Allergy: A Remaining Clinical Challenge. In: Journal of Allergy and Clinical Immunology: In Practice, 2017, vol. 5, n° 2, p. 296-300. https://archive-ouverte.unige.ch/unige:91076

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Deposited on : 2017-01-13

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