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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2017

Open Access 01-12-2017 | Brief communication

Low percentage of clinically relevant pistachio nut and mango co-sensitisation in cashew nut sensitised children

Authors: J. P. M. van der Valk, R. el Bouche, R. Gerth van Wijk, H. de Groot, H. J. Wichers, A. E. J. Dubois, N. W. de Jong

Published in: Clinical and Translational Allergy | Issue 1/2017

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Abstract

Background

Cashew nut, pistachio nut and mango belong to the Anacardiaceae family and are botanically related. Therefore, cashew nut sensitised children are frequently advised to eliminate cashew nuts and pistachio nuts from their diet. The ‘Improvement of Diagnostic mEthods for ALlergy assessment (IDEAL trial number NTR3572) study showed that cashew nut sensitised children were co-sensitised to pistachio nut in 98% of cases and to mango in 21% of cases. The aim of this follow-up study to IDEAL is to assess the clinical relevance of co-sensitisation to pistachio nut and mango in cashew nut sensitised children.

Methods

Children were recruited from the study: ‘Improvement of Diagnostic mEthods for ALlergy assessment (IDEAL trial number NTR3572). Inclusion criterion for the IDEAL study was sensitization to cashew nut as demonstrated by either SPT or sIgE, and a clinical history of reactions to cashew nuts or no previous (known) exposure. Sensitized children who were tolerant to cashew nuts were excluded. Inclusion criterion for this IDEAL follow-up study was co-sensitization to pistachio nut, regardless the result of the DBPCFC with cashew nut. In this follow-up study a double-blind placebo-controlled food challenge with pistachio nut and an open food challenge with mango were performed.

Results

Twenty-nine children (mean age of 11.6 years, 62% male) were included. Pistachio nut sensitisation was clinically relevant in only 34% of cashew-sensitised children and only 31% of cashew challenge positive children. None of the children was challenge positive to mango.

Conclusion

Although co-sensitisation between cashew nut and pistachio nut was observed in 98%, pistachio nut sensitisation was only clinically relevant in 34% of the children. Therefore, a challenge test with pistachio nut is recommended in children with cashew nut and pistachio nut sensitisation.
Trial registration The study was registered in the Dutch trial register (registration number 3572) on 10 August 2012 (retrospectively registered)
Literature
1.
Garcia F, Moneo I, Fernandez B, Garcia-Menaya JM, Blanco J, Juste S. Allergy to Anacardiacae: description of cashew and pistachio nut allergens. J Investig Allergy Clin Immunol. 2000;10:173–7.
2.
Quercia O, Raffanelli S, Marsigli L, Foschi FG, Stefanini GF. Unexpected anaphylaxis to cashew nut. Allergy. 1999;54:895–7.CrossRefPubMed
3.
Parra FM, Cuevas M, Lezaun A, Alonso MD, Beristain AM, Losada E. Pistachio nut hypersensitivity: identification of pistachio nut allergens. Clin Exp Allergy. 1993;23(12):996–1001.CrossRefPubMed
4.
Willison LN, Tawde P, Robotham JM, Penney RM, Teuber SS, Sathe SK, et al. Pistachio vicilin, Pis v 3, is immunoglobulin E-reactive and cross-reacts with the homologous cashew allergen, Ana o 1. Clin Exp Allergy. 2008;38(7):1229–38.CrossRefPubMed
5.
Noorbakhsh R, Mortazavi SA, Sankian M, Shahidi F, Tehrani M, Azad FJ, et al. Pistachio allergy-prevalence and in vitro cross-reactivity with other nuts. Allergol Int. 2011;60(4):425–32.CrossRefPubMed
6.
Hasegawa M, Inomata N, Yamazaki H, Morita A, Kirino M, Ikezawa Z. Clinical features of four cases with cashew nut allergy and cross-reactivity between cashew nut and pistachio. Allergol Int. 2009;58(2):209–15.CrossRefPubMed
7.
Van der Valk JPM, Dubois AEJ, Gerth van Wijk R, Wichers HJ, de Jong NW. Systematic review on cashew nut allergy. Allergy. 2014;69(6):692–8.CrossRefPubMed
8.
van der Valk JPM, van Wijk RG, Dubois AE, de Groot H, Reitsma M, Vlieg-Boerstra B, Savelkoul HF, Wichers HJ, de Jong NW. Multicentre double-blind placebo-controlled food challenge study in cashew sensitised children. PLoS One 2016;11(3). doi:10.​1371/​journal.​pone.​0151055.
9.
Skypala IJ, Venter C, Meyer R, de Jong NW, Fox AT, Groetch M, Oude Elberink JN, Sprikkelman A, et al. The development of a standardised diet history tool to support the diagnosis of food allergy. Clin Transl Allergy. 2015;5:7.CrossRefPubMedPubMedCentral
10.
Van der Valk JPM, Gerth van Wijk R, Hoorn E, Groenendijk L, Groenendijk IM, de Jong NW. Measurement and interpretation of skin prick test results. Clin Transl Allergy. 2016;6:8.CrossRefPubMedPubMedCentral
11.
Vlieg-Boerstra BJ, Herpertz I, Pasker L, van der Heide S, Kukler J, Jansink C, et al. Validation of novel recipes for double-blind, placebo-controlled food challenges in children and adults. Allergy. 2011;66(7):948–54.CrossRefPubMed
12.
Muraro A, Roberts G, Worm M, Bilo MB, Brockow K, Fernandez Rivas M, et al. Anaphylaxis: guidelines from the European academy of allergy and clinical immunology. Allergy. 2014;69(8):1026–45.CrossRefPubMed
13.
Rance F, Bidat E, Bourrier T, Sabouraud D. Cashew allergy: observations of 42 children without associated peanut allergy. Allergy. 2003;58:1311–4.CrossRefPubMed
14.
Sansosti A, Ferre Ybarz L, De La Borbolla M, Gomez Galan C, Nevot Falco S. Allergy to cashew nuts. Allergy. 2011;66:394.
15.
Fernandez C, Fiandor A, Martinez-Garate A, Martinez Quesada J. Allergy to pistachio: crossreactivity between pistachio nut and other Anacardiaceae. Clin Exp Allergy. 1995;25:1254–9.CrossRefPubMed
16.
Flinterman AE, Knulst AC, Meijer Y, Bruijnzeel-Koomen CAFM, Pasmans SG. Acute allergic reactions in children with AEDS after prolonged cow’s milk elimination diets. Allergy. 2006;61(3):370–4.CrossRefPubMed
Metadata
Title
Low percentage of clinically relevant pistachio nut and mango co-sensitisation in cashew nut sensitised children
Authors
J. P. M. van der Valk
R. el Bouche
R. Gerth van Wijk
H. de Groot
H. J. Wichers
A. E. J. Dubois
N. W. de Jong
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2017
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-017-0145-z

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