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Nut Co-Allergies Fewer Than Indicated by Positive Tests

peanut allergies vs other nutsA new study shows that virtually all test subjects allergic to peanut were in fact not clinically allergic to other nuts, despite positive skin or blood test results for those other nuts. An oral food challenge, administered by an allergist, was found to be the most accurate way to determine nut co-allergies.
Specifically, the researchers found that almond might be introduced into the diet of patients with peanut allergy without the need to perform skin prick tests, sIgE or oral food challenges because 100% of subjects in their study actually passed the almond nut oral challenge.

A summary of the study is included below…

Nut allergy tests ‘inaccurate’
29 March 2017

Skin and blood testing is an inaccurate way of identifying nut co-allergies, experts warn.

That’s because people can show a positive reading, without being truly allergic.

An oral food challenge gives a much clearer, objective result, they say.

Pointing to the latest evidence, US immunologists say that about 50% percent of those who thought they were allergic to all tree nuts were able to pass an oral food challenge without a reaction.

The study notes that almost none of the people allergic to peanut, but sensitised to tree nut, were clinically allergic to tree nut. The authors are now questioning the clinical relevance of “co-allergy”.

They say theirs is the first study indicating that peanut allergic people may not need to avoid all nuts.

Their findings from a retrospective analysis involving more than 100 people with apparent co-allergies suggest tree-nut sensitisation per se is difficult to interpret, poorly specific and can lead to potentially unnecessary food avoidance.

The authors recommend that an oral food challenge should be performed despite sensitisation to further clarify the clinical relevance of positive test results.

“Given the high success rate of tree-nut oral food challenge in individuals with peanut allergy, regardless of positive tree-nut test results, we question the value of performing screening tree-nut skin prick test or sIgE in patients without lifetime tree-nut exposure,” they write in the Annals of Allergy, Asthma and Immunology.

“More specifically, we found that almond might be introduced into the diet of patients with peanut allergy without the need to perform skin prick tests, sIgE, and/or oral food challenges because 100% passed the almond challenge in our sample.”

Article above courtesy of

You can read the actual medical study here