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The relevance of oral food challenge in a patient allergic to peanut and tree nuts

Peanut allergy is one of the most common food allergies in childhood. In vitro cross-sensitization between peanut and tree nuts (TN) is high, but only a subgroup of patients allergic to peanut will have a concomitant allergy to one or several TN. In this article, the authors report a case of a 12-ye...

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Autores principales: Limão, Rita, Bartolomé, Borja, Cabral Duarte, Fátima
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516310/
https://www.ncbi.nlm.nih.gov/pubmed/37744961
http://dx.doi.org/10.5415/apallergy.0000000000000109
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author Limão, Rita
Bartolomé, Borja
Cabral Duarte, Fátima
author_facet Limão, Rita
Bartolomé, Borja
Cabral Duarte, Fátima
author_sort Limão, Rita
collection PubMed
description Peanut allergy is one of the most common food allergies in childhood. In vitro cross-sensitization between peanut and tree nuts (TN) is high, but only a subgroup of patients allergic to peanut will have a concomitant allergy to one or several TN. In this article, the authors report a case of a 12-year-old boy who experienced 1 episode of lips and mouth itching, generalized urticarial, and eyelid angioedema 20 minutes after ingestion of peanut at 4 years of age. The immunoallergological study revealed the presence of a concomitant allergy to peanut, pistachio, and cashew confirmed with medically supervised oral food challenges (OFC) in a child who had never eaten these TN. The mechanism of IgE-mediated hypersensitivity was demonstrated by positive skin prick tests (SPT) with commercial extracts, although the specific IgE (sIgE) for these foods was negative. As described in the literature, we concluded that serum peanut and TN sIgE measurements have lower sensitivity than SPT to assess IgE sensitization, and OFC is the gold standard for accurate diagnosis of food allergy. We highlight the relevance of excluding or confirming TN allergy in a peanut-allergic patient who had never ingested certain TN, and of knowing the clinical relevant cross-reactivity patterns between TN, pistachio/cashew, and walnut/pecan, that could reduce the need for OFC in clinical practice, reducing allergy rates and financial and health burdens of food allergy.
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spelling pubmed-105163102023-09-23 The relevance of oral food challenge in a patient allergic to peanut and tree nuts Limão, Rita Bartolomé, Borja Cabral Duarte, Fátima Asia Pac Allergy Case Report Peanut allergy is one of the most common food allergies in childhood. In vitro cross-sensitization between peanut and tree nuts (TN) is high, but only a subgroup of patients allergic to peanut will have a concomitant allergy to one or several TN. In this article, the authors report a case of a 12-year-old boy who experienced 1 episode of lips and mouth itching, generalized urticarial, and eyelid angioedema 20 minutes after ingestion of peanut at 4 years of age. The immunoallergological study revealed the presence of a concomitant allergy to peanut, pistachio, and cashew confirmed with medically supervised oral food challenges (OFC) in a child who had never eaten these TN. The mechanism of IgE-mediated hypersensitivity was demonstrated by positive skin prick tests (SPT) with commercial extracts, although the specific IgE (sIgE) for these foods was negative. As described in the literature, we concluded that serum peanut and TN sIgE measurements have lower sensitivity than SPT to assess IgE sensitization, and OFC is the gold standard for accurate diagnosis of food allergy. We highlight the relevance of excluding or confirming TN allergy in a peanut-allergic patient who had never ingested certain TN, and of knowing the clinical relevant cross-reactivity patterns between TN, pistachio/cashew, and walnut/pecan, that could reduce the need for OFC in clinical practice, reducing allergy rates and financial and health burdens of food allergy. Lippincott Williams & Wilkins 2023-09-07 2023-09 /pmc/articles/PMC10516310/ /pubmed/37744961 http://dx.doi.org/10.5415/apallergy.0000000000000109 Text en Copyright © 2023. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Limão, Rita
Bartolomé, Borja
Cabral Duarte, Fátima
The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title_full The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title_fullStr The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title_full_unstemmed The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title_short The relevance of oral food challenge in a patient allergic to peanut and tree nuts
title_sort relevance of oral food challenge in a patient allergic to peanut and tree nuts
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516310/
https://www.ncbi.nlm.nih.gov/pubmed/37744961
http://dx.doi.org/10.5415/apallergy.0000000000000109
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