Prevalence of Peanut and Tree Nut Allergy and Sensitization in an Urban Clinic Population
Monday, March 5, 2018
South Hall A2 (Convention Center)
Joyce E. Yu, MD FAAAAI

Given the increasing prevalence of peanut and tree nut allergies, we sought to assess the frequency of sensitization to peanut and tree nuts in an urban inner city population.


We performed a retrospective chart review of 61 patients, 11 months to 18 years, diagnosed with food allergy in the pediatric allergy clinic. Clinical history, prick skin testing (PST) and serum IgE (sIgE) for peanut and tree nuts (almond, brazil nut, cashew, hazelnut, macadamia, pecan, pistachio, and walnut) were reviewed.


Subjects included 38 males and 23 females. Nearly half (47.5%) had a history of a clinical reaction to peanut. An additional 29.5% were avoiding peanut with a positive prick skin testing (PST) (>3mm wheal) and/or serum IgE (sIgE) (>0.35 kUA/L) but without a clinical history of reaction. The majority (85.2%) had a positive PST and/or sIgE to at least one tree nut but only 39.3% of subjects reported a clinical history of a reaction to one or more tree nut, most commonly cashew (20%), hazelnut (10%), walnut (9%), and almond (7%). Almost half (47.5%) continued avoiding all other tree nuts which had an associated lack of clinical history, negative PST and/or sIgE testing. Only 24.6% of subjects underwent food challenge (8 peanut, 7 tree nut) with 7 failed challenges (mean sIgE 1.16 kUA/L, range 0.1-2.56).


Although sensitization to peanut and multiple tree nuts is very prevalent in this inner city population, there is also a high rate of avoidance of peanut and tree nuts without a convincing clinical history or positive testing.