Definitive diagnosis of nut allergy.
OBJECTIVE
To compare findings of tests for nut allergy in children.


METHODS
Retrospective survey of a clinical practice protocol.


METHODS
Children's hospital paediatric outpatient clinic.


METHODS
96 children referred by general practitioners and accident and emergency doctors over 27 months (1994-96).


METHODS
Allergic manifestations (generalised urticarial rash, facial swelling, bronchospasm, anaphylactic shock, vomiting on three occasions) related to specific nut IgE concentrations and following touch, skin prick, or oral ingestion of nuts.


RESULTS
16 children from a sample of 51 who were tested for nut allergy had no reaction to an oral challenge. Positive IgE against peanuts was found in nine of these 16 children.


CONCLUSIONS
Skin prick testing and IgE measured by radioallergosorbent testing are inadequate tests for nut allergy. The definitive diagnostic test for nut allergy in the hospital setting is direct oral challenge.
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D010367:Arachis / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis*; D007073:Immunoglobulin E / Q000097:blood*; D007223:Infant; D009754:Nuts / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012882:Skin Tests