Pediatr Allergy Respir Dis.  2011 Dec;21(4):261-268.

Clinical Characteristics of Walnut Allergy and Evaluation of Cross-Reactivity between Walnut and Peanut in Children Under 4 Years of Age

• Lee JM
• Kim EJ
• Kwon DG
• Lee SY

Abstract

PURPOSE
Walnut (WN) allergy in young children has rarely been reported in Asia. This study focused on the clinical characteristics of WN allergy, co-sensitization, and cross-reactivity between WN and peanut (PN) in young Korean children.
METHODS
This study was based on a data analysis of 22 patients, all under the age of 4 years, who were diagnosed with allergic disease at Ajou University Hospital from January 2009 to December 2010. They were suspected to have a WN allergy or needed a screening examination to exclude food allergy. Sera from all children were analyzed for PN-, WN-, and pine nut-specific immunoglobulin E (IgE) (ImmunoCAP). Clinical details, feeding, and familial history of patients were collected by medical history. Additionally, we produced WN, PN, and pine nut extracts, and sera were tested with an enzyme linked immunosorbentassay inhibition test.
RESULTS
The subjects were 16 male and 6 female with a median aged of 24 months. Ten of 22 had a definite history of WN exposure. Among them, two (4.28 kU/L, 11.1 kU/L) were diagnosed with anaphylaxis, four (7.34 to 27.4 kU/L) were diagnosed with angioedema, and four (1.35 to 3.17 kU/L) were diagnosed with urticaria. We confirmed that PN in the IgE-ELISA was profoundly inhibited by the WN extract.
CONCLUSION
This study identified multiple cases of WN allergy in young children in Korea, indicating that it is not rare. Co-sensitization and clinical adverse reactions between PN and WN suggests that more investigations are needed to conclude cross-reactivity between PN and WN.

Keyword

Walnut; Anaphylaxis; Food allergy

MeSH Terms

Aged
Anaphylaxis
Angioedema
Asia
Child
Female
Food Hypersensitivity
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Juglans
Korea
Male
Mass Screening
Nuts
Statistics as Topic
Urticaria
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1. Peanut immunoglobulin E-enzyme linked immunosorbentassay inhibition test using inhibitors; crude extract of peanut, walnut, pine nut, soybean and house dust mite.

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  Fig. 2. Walnut immunoglobulin E-enzyme linked immunosorbentassay inhibition test using inhibitors; crude extract of peanut, walnut, pine nut, soybean and house dust mite.

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