![]() © 2022 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. Safety is similar to OIT for other foods.Īllergy cashew cross-reactivity immunotherapy tree nuts. All (n = 44) patients consuming a low cashew dose for ≥6 months following desensitization passed a full-dose cashew OFC.Ĭashew OIT desensitizes most cashew-allergic patients and cross-desensitizes to pistachio. Following cashew desensitization, all pistachio (n = 35) and four of eight walnut co-allergic patients were cross-desensitized to the respective nut. Desensitized patients had decreased SPT, sIgE, basophil reactivity, and increased sIgG4, following treatment. Three patients (6%) were treated with injectable epinephrine for home reactions. An additional three patients were desensitized to 1200 mg cashew protein, and three patients stopped treatment. Patients with co-allergy to pistachio or walnut were challenged to the respective nut.įorty-four of 50 OIT-treated patients (88%) compared to 0% in controls tolerated a dose of 4000 mg cashew protein at the end of the study (odds ratio 8.3, 95% CI 3.9-17.7, p < 0.001). Patients fully desensitized to cashew were instructed to consume a dose of 1200 mg cashew protein for 6 months and were then challenged to a full dose. Full desensitization rate and associated immunological changes in both groups were compared. Co-allergy to pistachio and walnut was determined. ![]() His SPT was 13 mm wheal to pistachio (cashew was unavailable) and his specific IgE was 7.44 to both cashew and pistachio. Fifteen cashew-allergic patients who continued cashew elimination served as observational controls. JanuPeanuts and Anaphylaxis Due to Cashew Nut Question: Recently I saw a one year-old child with a history of well-controlled eczema with anaphylaxis to cashew nut. Oral immunotherapy (OIT) is a treatment option for patients with milk, egg, and peanut allergy, but data on the efficacy and safety of cashew OIT are limited.Ī cohort of 50 cashew-allergic patients aged ≥4 years, who were consecutively enrolled into cashew OIT (target dose 4000 mg protein) between 4/2016 and 12/2019. ![]()
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