[Allergy to macadamia nut].

The patient was a 23-year-old female with a history of atopic dermatitis, allergic rhinitis, and allergic conjunctivitis. In her fourth year of primary school, she ate macadamia nuts and developed oral discomfort and generalized uticaria. In her second year of junior high school, she ate macadamia nuts and developed oral and pharyngeal discomfort, followed by generalized uticaria and dyspnea. At the age of 20 years, she also developed oral discomfort after eating vegetables in a Chinese dish containing macadamia nuts and visited our department for close examination. A scratch test of extract oil (concentration, as is) was positive, and a diagnosis of immediate allergy due to macadamia nuts was made. Thereafter, she avoided macadamia nuts completely and had no further recurrence. This patient developed oral allergy syndrome (OAS) after eating macadamia nuts. However, she was negative for Bet v1 and Bet v2 as allergens in white birch pollinosis, in which OAS has been most frequently reported. She had Japanese cedar pollinosis, but its onset was when she was in her second year of high school. Therefore, it is unlikely that Japanese cedar pollen is a sensitization antigen for macadamia nut allergy.