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Nederlands Tijdschrift voor Geneeskunde 2007-May

[Allergy to cashew nuts and peanuts].

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Anaphylaxis due to the ingestion of peanuts is a serious, common condition, known to both the general public and physicians. Recently, an increasing number ofpatients with an anaphylactic reaction after eating small amounts of cashew nuts have been reported. In three children, a boy aged 7 and two girls aged 9 and 10 years, respectively, with heterogeneous case histories involving allergic upper airway and conjunctival symptoms and constitutional eczema, allergy for cashew nuts was diagnosed in the first two and allergy for peanuts in the third. They were given dietary advice and an adrenaline auto-injector for emergencies. In most cases, a detailed food history, together with the demonstration of IgE against cashew nuts by means of serology or skin prick tests, are sufficient to establish the diagnosis. If the clinical relevance of a sensitisation to cashew nuts is unknown, a food provocation test may be necessary. The treatment consists of dietary intervention, and an adrenaline auto-injector is prescribed for a serious anaphylactic reaction. So far, three major allergens from the cashew nut (Anacardium occidentale) have been identified and purified.

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