Clinical and prognostic evaluation of legumes and tree nuts allergy in children

Abstract

Purpose - Allergy to legumes and tree nuts (TNs) is one of the most important causes of fatal and near-fatal food-induced allergic reactions. However, our knowledge of the clinical features of legumes and TN sallergies in children is limited. In this study, we aim to identify clinical characteristics, development of tolerance, risk factors of legumes and TNs allergies in children. Methods. - This retrospective study was designed at two cities at the west part of Turkey. Fifty-seven children with legumes and TNs diagnosed at Clinic of Pediatric Allergy of Balikesir University and Dr Behcet Uz Children Hospital for 2014-2018 years were examined. Current age, gender, age of onset of the legumes and/or TN allergy, the type of the allergic reactions, family history of atopy, results of skin prick test (SPT), and/or oral challenge test and presence of concomitant food allergies, tolerance development and cross reactions were recorded. Results. - In total, 83 allergies related with legumes and TNs were determined in 57 patients. Mean age of patients was 18.75 +/- 13 months and 40.4% were girl. Fifty-two of these reactions were related with legumes (62.6%) and 29.9% of patients had reaction with more than one. Peanut allergy was most common in legumes allergy (53.8%) and walnut allergy was most common in TNs allergy (54.8%). Urticaria was most common type of allergic reaction (56.6%), 28.9% of reactions were anaphylaxis. No statistically significant difference was found between legumes and TNs in terms of the frequency of development of anaphylaxis (P = 0.062). Concomitant food allergy was present 80.7% of patients. Patients with legume allergy had significantly high hazelnut and walnut allergy (P = 0.04, P < 0.001, respectively). Significantly, high peanut and lentil allergy were detected in patients with TNs allergy (P = 0.01, P = 0.026, respectively). There was co-sensitization and co-allergy between legumes and TNs in children as expected. Tolerance development was shown in 12.2% of patients. Conclusions. - In addition to other food allergies, legumes/TNs allergies are also observed to occur with increasing frequency in children. Co-sensitization and co-allergy between legumes and TNs are frequent. Tolerance development for legumes/TNs allergies is expectedly low. (c) 2022 Elsevier Masson SAS. All rights reserved.