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Clinical presentation of cashew nut allergy in a paediatric cohort attending an allergy clinic in the West of Ireland

  • Miranda Crealey
  • Salma Alamin
  • Vincent Tormey
  • Edina Moylett
Brief Report

Abstract

Background

Cashew nut (CN) allergy appears to be increasing. Reactions are variable and may include anaphylaxis.

Aim

To describe the clinical features of CN allergy in a group of children attending an allergy clinic with suspected peanut allergy and confirmed sensitisation to CN.

Methods

Patients were identified retrospectively by reviewing the Immunology Database at University Hospital Galway over a 5-year period, Oct. 2010 to Sept. 2015. Patients confirmed sensitised to CN (specific IgE > 0.35 kUa/L, ImmunoCAP Assay) were selected and contacted.

Results

Over the 5-year period, 115 children were identified; 102/115 were individually contacted. Of the 102 children, 55 had a history of prior CN exposure with confirmed clinical reaction, 43 had no prior CN exposure, and 4 were sensitised and tolerating CN. For those with clinical CN allergy (N = 55), 30 (55%) were male and median age of onset was 2 years (lower quartile 1.5, upper quartile 4.8). Severity of reaction was graded as mild for 13 children, moderate in 13 additional children, and severe in 29 children. Median CN serum IgE level was 3.2 kUa/L (range 0.36 to > 100) in the clinical reaction group, 2.91 kUa/L (range 0.36 to > 100) in the sensitised group, and 3.4 kUa/L (range 0.94 to 5.21) in those tolerating CN. IgE values were not significantly different between those with mild, moderate, or severe reaction to CN (p = 0.346).

Conclusion

Children are ingesting CN at a young age with more than half of allergic reactions reportedly severe in nature. The specific CN IgE value was not helpful in predicting severity of reactions.

Keywords

Anaphylaxis Cashew nut IgE-mediated allergy Sensitisation Tree nut allergy 

Notes

Compliance with ethical standards

Ethics approval to carry out this study was obtained by the Ethics Committee in University Hospital Galway, Ireland.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Royal Academy of Medicine in Ireland 2018

Authors and Affiliations

  • Miranda Crealey
    • 1
  • Salma Alamin
    • 2
  • Vincent Tormey
    • 2
  • Edina Moylett
    • 1
  1. 1.Academic Department of PaediatricsNational University of IrelandGalwayIreland
  2. 2.Department of ImmunologyGalway University HospitalGalwayIreland

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