Nut allergies are common food allergens that can cause serious allergic reactions. Nuts are consumed raw, processed or in bakery products. Consumption of nuts is increasing due to their cholesterol-lowering effects and positive effects on the cardiovascular system. The nine nuts that most commonly cause allergic reactions are walnuts, almonds, pistachios, cashews, pecans, hazelnuts, macadamia nuts, Brazil nuts, and pine nuts. Although peanut is a common allergen, it is an allergen belonging to the legume family.
Clinical symptoms
Nut allergies develop from the age of 2 and nuts to which they are sensitive increase with age. may increase. Most patients experience a reaction when they first eat it. Reactions to nuts can be very serious. Peanuts and nuts are responsible for 70-90% of food-related anaphylactic (severe allergic reaction) reactions. Concomitant allergic rhinitis, asthma and eczema may cause allergic reactions to nuts to be more severe. Being asthmatic is alone a risk factor for the severity of the reaction.
Pollen-food syndrome is also common with nuts. Some allergenic proteins in pollen are similar to allergenic proteins, especially in almonds and hazelnuts. The symptoms of pollen food syndrome are mild. Itching, erythema, tingling and mild edema in the mouth and palate are usually observed.
Accidental ingestion of nuts is common. It has been determined that the majority of patients who know that they are allergic to peanuts and other nuts develop more than five reactions with these allergens throughout their lives.
Nut allergies are less likely to go away compared to other allergens. Especially at the time of diagnosis, the patient's high serum specific IgE (test for nuts that cause allergic reactions in the blood) and allergic response to many nuts reduce the probability of diagnosis.
Diagnosis
In nut allergies, allergic symptoms that occur after consuming nuts can be diagnosed by serum specific IgE, skin test and, if necessary, by starting with a small dose of the food and gradually increasing it, under the supervision of a doctor.
Di� Another diagnostic method is molecular allergy tests, which are increasingly used in diagnosis in recent years and provide information about the course of allergic disease. While skin tests and specific IgE values give results for the entire allergenic protein, molecular allergy tests give results for the protein that causes the most allergic reactions in the allergenic food. This provides us with information about the course of the disease. For example, if the allergen detected by molecular allergy testing is resistant to heat, that is, cooking, the risk of severe reactions is higher. On the other hand, if we find high levels of allergens that are similar to plants, it means that milder reactions will occur.
Hazelnut
Hazelnut comes from the same origin as birch. Therefore, sensitivity to hazelnuts may also be detected in the tests of those who are allergic to birch. We can distinguish with molecular allergy tests whether the hazelnut allergy detected in the tests is due to allergy to birch or is actually caused by sensitivity to hazelnuts. Molecular allergy tests defined in hazelnut allergies are Cor a 1, Cor a 2, Cor a 8, Cor a 9, Cor a 14. The interpretation of these tests by the doctor is that the symptoms are due to birch tree allergy or real hazelnut allergy. can be found.
Cashew and Pistachios
Cashew and pistachios It comes from related plants. Usually, allergic sensitivity to both of them is detected. One study found that 98% of children who consumed cashews also consumed pistachios. These two allergens can often cause a serious allergic reaction with small amounts of consumption.
Cashews and pistachios are frequently seen in industrial countries, as the popularity of these foods increases. Cashew is frequently consumed in Asian cuisine, in cakes, chocolate and pesto sauce.
Molecular allergy tests for cashew allergy are Ana o 1, Ana o 2 and Ana o 3. The allergens identified in molecular allergy tests for pistachios are Pis v 1 and Pis v2. With the interpretation of these tests by the doctor, the risk of cashew allergy and accompanying pistachio allergy can be determined.
Walnuts and Pecans
Ce Walnut and pecan originate from similar plants. Allergy to pecans is less common due to lower consumption.
Allergens identified for walnut allergy in molecular allergy tests are Jug r 1, Jug r 2, Jug r 3, Jug r 4 and Jug r 5. . However, not all of these identified molecular allergens cause serious reactions with walnuts. The risk of serious walnut allergy can be determined by the doctor's interpretation of these tests.
The allergens detected in molecular allergy tests for pecans are Car i 1 and Car i 4. These allergens have similar properties to Jug r 1 and Jug r 4 detected in walnuts.
Almond
Almond is generally consumed roasted or as almond milk or butter. . Sensitivity to almonds is generally strongly associated with birch allergy.
Allergens detected in molecular allergy tests were determined as Pr du 6, Pru du 3 and Pru d4, but their clinical significance has not been determined
Pine nuts
Pine nuts are used in salads, Italian dishes, baklava or stuffed meatballs. Although pine nut allergy is rare compared to others, it can cause a severe allergic reaction on its own. The pine nut allergen identified in molecular allergy tests is Pin p 1.
Peanut
Peanut, as a plant origin, shares common features with legumes, not nuts. However, nut allergy, along with peanuts, is seen at a rate of 20-68%. Peanuts are consumed in many ways, roasted, raw, or crushed. Peanuts contain 24-29% protein and they contain many different allergens. Roasting peanuts at high temperatures increases their allergenic properties, while cooking them can reduce them.
There are many allergens in peanuts that have been detected by molecular allergy tests. These allergens detected in molecular tests are Ara h 2, Ara h 3, Ara h 5, Ara h 6, Ara h 8 and Ara h 9. With the interpretation of these tests by the doctor, it can be determined that the symptoms are caused by birch allergy or real hazelnut allergy. In addition, a risk of serious peanut allergy may be detected.
Treatment
The identified allergen should be avoided and accidental ingestions should be avoided. The adrenaline auto-injector should always be with the patient in order to intervene promptly. Care should be taken to read the labels, and explanations such as small amounts or traces should be taken into consideration.
Oral, skin or sublingual vaccine options in food allergy are still at the research level. There is not enough information about giving these foods earlier or later than normal to protect against nut allergies. In general, it is recommended to start in accordance with the family's eating habits.
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