Healio: Tree nut allergy diagnosis poses challenges

By Janel Miller

Data presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting indicate that tree nut allergies are responsible for up to 40% of anaphylaxis reactions. Also, when combined with peanuts, tree nut allergies account for up to 90% of anaphylactic fatalities.

Healio has previously reported that despite exhibiting skin or blood test sensitivity to peanuts and tree nuts, more than 50% of patients with a documented allergy to an individual nut passed oral food challenges consisting of additional nuts.

That data, coupled with a discussion held by Maria Crain, APRN, CPNP-PC, AE-C, a pediatric nurse practitioner at the Food Allergy Center within Children’s Health in Dallas, and Jodi Shroba, MSN, APRN, CPNP, of the division of allergy and immunology at Children’s Mercy Hospital in Kansas City, Missouri, suggest tree nut allergy diagnosis is not always cut and dry.

One diagnostic test mentioned, Component Resolved Diagnostic Testing, “may give you a better understanding of what a patient’s IgE levels are and can differentiate between reactivity and actual food allergy,” Shroba told attendees.

In addition, “we have a lot of teenaged patients who avoid food allergy tests [for as long as possible],” Crain said. “This can cause anxiety, which can cause difficulties determining if it is anxiety or the food causing the allergy symptoms. And with infants and young children, it may be harder to get them to eat the amount that you need them to.”

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Learn more about Allergy & Immunology at Children's Mercy