Most frequent elicitors of tree nut-induced anaphylaxis in children were cashew, hazelnut, walnut
By Elana Gotkine HealthDay Reporter
WEDNESDAY, July 9, 2025 (HealthDay News) — Cashew is an increasingly relevant allergen leading to anaphylaxis in children, according to a study published online June 13 in Allergy.
Veronika Höfer, from Charité Universitätsmedizin Berlin, and colleagues extracted cases of tree nut-induced anaphylaxis (TIA) registered from 2007 until April 2024 from the European Anaphylaxis Registry and analyzed them.
Among 5,945 registered food-induced reactions, 1,389 cases of TIA were identified (23 percent). Further analysis included 1,083 cases with confirmed elicitor status (845 children and 238 adults). The researchers found that among children, the most frequent elicitors were cashew, hazelnut, and walnut (334, 211, and 146, respectively). From 2007 to 2024, the proportion of cashew-induced anaphylaxis increased and reactions were often caused by small amounts (less than one teaspoon). Adults often reacted to hazelnut, walnut, and almond (105, 47, and 35, respectively) and to higher amounts. Fifty percent of adults and 17 percent of children had potential cofactors present. Reaction severity was independent of age. Few patients were previously aware of their allergy (23 and 21 percent of children and adults, respectively). In lay treatment, use of adrenaline was low (13 and 3 percent among children and adults, respectively) and reached about 40 percent upon professional treatment.
“Tree nuts resemble the largest elicitor group among all food-induced reactions in the European Anaphylaxis Registry, and cashew-induced anaphylaxis is on the rise among pediatric patients,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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