Tree Nuts Anaphylaxis in Preschool Age Children.

Area of Science:

• Pediatric Allergy and Immunology
• Food Hypersensitivity
• Clinical Immunology

Background:

• Food-induced anaphylaxis (FIA) incidence is increasing in young children.
• While milk and egg are common, tree nut (TN) allergies are rising.
• TNs-FIA requires characterization in preschool-aged children.

Purpose of the Study:

• To characterize preschool-aged children with TNs-induced anaphylaxis (TNs-FIA).
• To identify common TN allergens and reaction patterns.
• To assess cross-reactivity and co-sensitization in TN allergy.

Main Methods:

• Retrospective study of 25 children with preschool TNs-FIA.
• Allergological work-up including skin prick tests and specific IgE.
• Analysis of clinical history, reaction timing, symptoms, and co-sensitization.

Main Results:

• Cashew and walnut were the most frequent culprits.
• Reactions often occurred within 30 minutes of first known ingestion (68%).
• 84% showed cross-reactivity with other TNs; 36% with peanut.

Conclusions:

• Cashew and walnut are primary TN allergens in preschool FIA.
• TNs-FIA reactions are rapid and can be severe, even with small exposures.
• Early diagnosis and management are crucial due to potential severity and co-sensitization.