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Food allergy: nuts and tree nuts

Published online by Cambridge University Press:  19 April 2007

Jesus F. Crespo ,
John M. James ,
Consuelo Fernandez-Rodriguez  and
Julia Rodriguez
Jesus F. Crespo*
Affiliation:
Hospital Universitario Doce de Octubre, Madrid, Spain
John M. James
Affiliation:
Colorado Allergy and Asthma Centers, Fort Collins, CO, USA
Consuelo Fernandez-Rodriguez
Affiliation:
Hospital Universitario Doce de Octubre, Madrid, Spain
Julia Rodriguez
Affiliation:
Hospital Universitario Doce de Octubre, Madrid, Spain
*
*Corresponding author: Jesus F. Crespo, fax +34 913908261, jfernandezc.hdoc@salud.madrid.org
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Abstract

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Nuts are a well-defined cause of food allergy, which affect approximately 1 % of the general population in the UK and the USA. There do appear to be differences in the frequency of nut allergy between different countries because of different dietary habits and cooking procedures. For example, in the USA and France, peanuts are one of the most frequent causes of food allergy, but in other countries, it seems to be less common. Genetic factors, in particular, appear to play a role in the development of peanut allergy. While the majority of nut allergens are seed storage proteins, other nut allergens are profilins and pathogenesis-related protein homologues, considered as panallergens because of their widespread distribution in plants. The presence of specific IgE antibodies to several nuts is a common clinical finding, but the clinical relevance of this cross-reactivity is usually limited. Allergic reactions to nuts appear to be particularly severe, sometimes even life-threatening, and fatal reactions following their ingestion have been documented. Food allergy is diagnosed by identifying an underlying immunological mechanism (i.e. allergic testing), and establishing a causal relationship between food ingestion and symptoms (i.e. oral challenges). In natural history investigations carried out in peanut-allergic children, approximately 20 % of the cases outgrew their allergy or developed oral tolerance. The treatment of nut allergies should include patient and family education about avoiding all presentations of the food and the potential for a severe reaction caused by accidental ingestion. Patients and families should be instructed how to recognise early symptoms of an allergic reaction and how to treat severe anaphylaxis promptly.

Keywords

Peanut allergyNut allergyTree nut allergyAllergensFood allergy
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Supplement S2 , November 2006 , pp. S95 - S102
Copyright
Copyright © The Nutrition Society 2006

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