Allergy to pine nuts in children

Allergy to nuts is a common and well-known disease. Despite the fact that pine nut is a widely eaten food, only nine cases have been described in literature.

To describe four paediatric patients suffering from allergy reaction on ingestion of pine nuts and compare them with cases described in literature, taking into account clinical symptoms, epidemiological and diagnostic methods.

The immuno-allergic study was carried out with skin tests (prick tests) using a commercial and native extract, and specific IgE serum test. An oral provocation test was performed in one case.

Ages ranged from 12 months to 6 years. All patients had a personal history of atopy. Symptoms on ingesting pine nut were severe systemic reactions in three cases. Two of the children had allergic reactions to other nuts. In all cases, both the skin test and the specific IgE serum test were positive. The oral provocation was positive in the case for which it was performed.

A typical clinical reaction of immediate hypersensitivity to this nut took place in all four children. The skin tests and in vitro studies confirm an IgE-mediated response. We currently have a commercial prick test for pine nut for the diagnosis, which has proven its sensitivity and specificity. In our region, due to the large consumption, the rate of allergic reactions to pine nuts would probably be greater and earlier on in life than in other areas.