Allergies to nuts – which sensitize the most and how is this allergy manifested?

It is believed that 1% of the population may suffer from nut allergy. In most cases, allergy is already visible in childhood. Most of the first reactions take place when the child is between 14 months and 2 years old. Allergy to nuts usually has a relatively severe course. Symptoms usually appear shortly after eating the allergen. 

The most sensitizing species are definitely peanuts (peanuts), then walnuts and hazelnuts, almonds and pistachios. Unfortunately, these are frequent ingredients of processed products – from pates, through breakfast products to bread. 


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Peanuts and other nut allergens 

The allergenic components of peanuts are Ara h1 and Ara h2 proteins. Although botanical peanuts belong to the legume family, their structure is very similar to the proteins of other nuts. Therefore, if someone is allergic to peanuts, they can react similarly to other peanut snacks. Raw and roasted nuts have higher allergenic properties than cooked and fried peanuts. Strongly allergenic products also include hazelnuts and Italian as well as edible chestnuts. 

Symptoms of nutty allergy 

Allergy to nuts can be manifested by skin changes (eg rash, urticaria and redness). Depending on the severity of the allergy and the amount of nuts eaten, more disturbing symptoms may appear, such as bronchospasm, sneezing and rhinitis. In relation to allergens, the digestive system is also not indifferent, which manifests itself with abdominal pain, diarrhea or other gastrointestinal disorders. 

A characteristic symptom of nut allergy is the oral allergy syndrome, the course of which includes swelling of the lips, throat and mouth of the tongue. The appearance of edema is preceded by burning or tingling. The most dangerous is anaphylactic shock. People who are at risk should carry a pre-filled syringe containing adrenaline. Anaphylactic shock is a life-threatening condition. Symptoms of nut allergy may be exacerbated by exercise, alcohol and the use of acetylsalicylic acid-containing medicines. 

Cross allergy – what is it? 

We are dealing with cross-allergy when the IgE antibodies produced by the allergic organism primarily to one allergen, recognize a similar protein from another allergen (one should distinguish the phenomenon of cross-allergy and the coexistence of allergy to several allergens). In people allergic to certain allergens, allergy symptoms may also appear under the influence of nuts and peanuts often cross-react with pollen, stone fruit (plum, peach), peas, celery, with raw tomato, latex, and the proper nuts often react cross with birch pollen, hazel, common ground, with stone fruit (plum, peach), kiwi, with flours (rye, wheat, oats), sesame, poppy seeds. 

Diagnosis of nut allergies 

Allergy to nuts is usually diagnosed after the patient develops symptoms characteristic of food allergies. The methods used to determine allergens are used, among others, skin prick tests, blood tests and provocative tests. The first of the tests consists in applying to the skin of a sick person a small amount of a preparation containing allergens derived from nuts. Then the skin is observed. If the patient is allergic, symptoms such as pruritus and redness will appear. The second test consists in taking a blood sample, which is then tested for the content of IgE antibodies and specific antibodies. The result of this study does not always allow you to make the final diagnosis. Provocative tests are very risky and can only be carried out in a hospital setting. They consist in controlled administration of a substance to the patient, which is suspected of causing allergy (in this case they would be nuts). 

Nuts only from the age of 3 

Due to the fact that nuts are a food with highly allergenic properties, they should not be served to children under the age of 3. Recent scientific reports may change this recommendation and move this age limit. Late introduction of nuts to the child’s diet may reduce the risk of acquired allergy, but this does not exclude it. Nut allergy is very difficult to treat – it requires the elimination of all products that contain them. For patients it means continuous reading of the labels (checking information about the presence of allergens in the product, but also information about whether the product may contain allergens) and avoiding restaurants where they can not get information on the content of nuts for the selected dish. Even traces of nuts can be harmful to them. 


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