Usefulness of open mixed nut challenges to exclude tree nut allergy in children

Francine C Van Erp; André C Knulst; Irene L Kok; Maartje F van Velzen; Cornelis K. van der Ent; Yolanda  Meijer

doi:10.1186/s13601-015-0062-y

Usefulness of open mixed nut challenges to exclude tree nut allergy in children

Francine C Van Erp^*, André C Knulst, Irene L Kok, Maartje F van Velzen, Cornelis K. van der Ent, Yolanda Meijer

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical. The usefulness of open mixed nut challenges in terms of safety, reactions during challenge, tolerance of the challenge material, effect on the elimination diet and satisfaction of the parents was evaluated.

FINDINGS: Open mixed nut challenges were performed in 19 children with a previous negative hazelnut challenge and long term elimination diet for tree nuts. Challenges were negative in 13 (68 %) children, in four (21 %) children (non-severe) allergic symptoms were observed. The challenges were well accepted, safe and efficient. We were able to avoid multiple nut challenges in 15 (79 %) children.

CONCLUSIONS: Open mixed nut challenge can efficiently exclude multiple tree nut allergies in children with a lifelong nut free diet and low suspicion of clinical allergy.

Original language	English
Article number	5
Pages (from-to)	19
Journal	Clinical and Translational Allergy
Volume	5
Issue number	1
DOIs	https://doi.org/10.1186/s13601-015-0062-y https://doi.org/10.1186/s13601-015-0062-y
Publication status	Published - 2015

Keywords

Tree nuts
Nut allergy
Diagnostics
Food challenge

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title = "Usefulness of open mixed nut challenges to exclude tree nut allergy in children",

abstract = "BACKGROUND: To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical. The usefulness of open mixed nut challenges in terms of safety, reactions during challenge, tolerance of the challenge material, effect on the elimination diet and satisfaction of the parents was evaluated.FINDINGS: Open mixed nut challenges were performed in 19 children with a previous negative hazelnut challenge and long term elimination diet for tree nuts. Challenges were negative in 13 (68 %) children, in four (21 %) children (non-severe) allergic symptoms were observed. The challenges were well accepted, safe and efficient. We were able to avoid multiple nut challenges in 15 (79 %) children.CONCLUSIONS: Open mixed nut challenge can efficiently exclude multiple tree nut allergies in children with a lifelong nut free diet and low suspicion of clinical allergy.",

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author = "{Van Erp}, {Francine C} and Knulst, {Andr{\'e} C} and Kok, {Irene L} and {van Velzen}, {Maartje F} and {van der Ent}, {Cornelis K.} and Yolanda Meijer",

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AU - Van Erp, Francine C

AU - Knulst, André C

AU - Kok, Irene L

AU - van Velzen, Maartje F

AU - van der Ent, Cornelis K.

AU - Meijer, Yolanda

PY - 2015

Y1 - 2015

N2 - BACKGROUND: To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical. The usefulness of open mixed nut challenges in terms of safety, reactions during challenge, tolerance of the challenge material, effect on the elimination diet and satisfaction of the parents was evaluated.FINDINGS: Open mixed nut challenges were performed in 19 children with a previous negative hazelnut challenge and long term elimination diet for tree nuts. Challenges were negative in 13 (68 %) children, in four (21 %) children (non-severe) allergic symptoms were observed. The challenges were well accepted, safe and efficient. We were able to avoid multiple nut challenges in 15 (79 %) children.CONCLUSIONS: Open mixed nut challenge can efficiently exclude multiple tree nut allergies in children with a lifelong nut free diet and low suspicion of clinical allergy.

AB - BACKGROUND: To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical. The usefulness of open mixed nut challenges in terms of safety, reactions during challenge, tolerance of the challenge material, effect on the elimination diet and satisfaction of the parents was evaluated.FINDINGS: Open mixed nut challenges were performed in 19 children with a previous negative hazelnut challenge and long term elimination diet for tree nuts. Challenges were negative in 13 (68 %) children, in four (21 %) children (non-severe) allergic symptoms were observed. The challenges were well accepted, safe and efficient. We were able to avoid multiple nut challenges in 15 (79 %) children.CONCLUSIONS: Open mixed nut challenge can efficiently exclude multiple tree nut allergies in children with a lifelong nut free diet and low suspicion of clinical allergy.

KW - Tree nuts

KW - Nut allergy

KW - Diagnostics

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Usefulness of open mixed nut challenges to exclude tree nut allergy in children

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Keywords

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