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Nine Percent of Children With Tree Nut Allergies Will Outgrow Their Allergy

A new study in the November 2005 Journal of Allergy & Clinical Immunology (JACI) reveals that about 9% of children with an allergy to tree nuts will outgrow their allergy, including children who have previously experienced a severe allergic reaction. The JACI is the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

It is estimated that 1%-2% of the United States population is allergic to peanuts, tree nuts or both. Tree nuts that can trigger allergic reactions include cashews, walnuts, almonds, hazelnuts, pecans, macadamia nuts, pistachios, and pine nuts. Although research has show that children allergic to peanuts have a 20% chance of outgrowing their allergy, before this current research, previous researchers thought that tree nut allergies lasted a lifetime.

A research team led by Robert A. Wood from Johns Hopkins University School of Medicine, evaluated 278 children, ranging from 3 to 21 years old, to find out the percentage of those who will outgrow their allergy. Because an oral food challenge is currently the best way to prove that a child has outgrown their food allergies, researchers also sought to determine what level of tree nut specific-IgE in the blood would be a safe level before testing the child in this manner.

Results of the study found that about 9% of children allergic tot ree nuts outgrow their allergy. This percentage includes those children who have had a pervious severe allergic reaction. The study also found, unfortunately, that children who are allergic to multiple types of tree nuts are unlikely to outgrow their allergy. Also, 58% of children with tree nut specific IgE levels of less than 5 kilounits per liter passed an oral challenge.

Based on these findings, researchers recommend that children with a current tree nut allergy be re-evaluated periodically by their allergist/immunologist to find out whether they have developed a tolerance and whether an oral challenge should be given.
Although an ideal cut-off has not been determined, researchers suggest that oral challenges should be taken into consideration for children four years old or older and who have less than five kilounits per liter of tree-nut specific IgE in their blood.

Because an allergy to tree nuts was previously thought to last a lifetime, few patients in the past ever underwent a re0evaluation to find out if their allergy still existed. Instead, these patients were instructed to avoid tree nuts and were prescribed epinephrine to take in case they had a severe allergic reaction. But now, thanks to new research, it is apparent that periodic reevaluation of a tree nut allergy is warranted. While only 9% will outgrow their allergy, researchers stress that it is important that these patients be identified so that they no longer need to worry about this otherwise potentially deadly allergy.

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