Characterization and Incidence of Sunflower Seed Allergy in a Pediatric Allergy Clinic

Sunflower seeds are a popular allergen-free peanut alternative.

To describe sunflower seed allergy incidence and characteristics.

We conducted a retrospective cohort study of patients with sunflower seed allergy from 1995 to 2021 in a pediatric allergy clinic. We described demographic characteristics, testing results, atopic comorbidities, and reaction histories of patients with sunflower seed allergy and calculated the annual cumulative incidence of the allergy. Logistic regression was used to estimate the increase in odds of sunflower seed allergy diagnosis for each year from 1995 to 2021.

From 1995 to 2021, we identified 235 patients with sunflower seed allergy. Among patients with sunflower seed allergy, the median age at diagnosis was 3.9 years. More than three-quarters of patients had another atopic condition. Half of the reactions consisted of mild urticaria or rash, and a quarter met criteria for anaphylaxis. The cumulative incidence ranged from 0% (1995-1999, 2001-2004, and 2006) to 0.38% (2021). From 1995 to 2021, the odds of sunflower seed allergy diagnosis increased annually by 21% (odds ratio, 1.21; 95% CI, 1.17-1.25).

In our single-center cohort of children with sunflower seed allergy, most children were diagnosed in early childhood, had high rates of comorbid atopic conditions, and had high rates of cutaneous reactions to sunflower seed products. Moreover, in our cohort, incidence of sunflower seed allergy increased.