Cashew reactions more severe than peanut

The incidence of cashew allergy has been reported to be increasing, and cashew allergy appears to invoke more severe reactions. Researchers in Texas have recently published a paper describing the clinical characteristics of cashew allergic patients attending the Texas Children's Hospital, compared to those allergic to peanut.

Patients were identified through a retrospective chart review, and a phone survey was conducted to identify the clinical characteristics of cashew allergic patients in comparison to peanut allergic patients. Patients were selected based on documentation or history of clinical allergy by questionnaire and chart review and positive specific IgE (>0.35 kU/L). Age at exposure, quantitative serum IgE, clinical presentation characteristics, and atopic history were recorded.

Results showed that patients with cashew allergy were more likely to experience anaphylaxis and less likely to have atopic dermatitis than patients with peanut allergy. Anaphylaxis was present in 50% of cashew and 25% of peanut allergic patients attending the hospital. Half of the cashew-allergic patients presented at the clinic with respiratory symptoms. Rates of asthma, allergic rhinitis, and concomitant food allergy were similar in both groups.

The authors concluded that cashew allergy was more likely to result in severe reactions such as anaphylaxis than peanut allergy. Because of this, cashew-allergic patients and their parents should be educated on the correct use of the epinephrine auto-injector and strictly avoid exposure to all tree nuts.

Reference: Grigg et al. 2009. Pediatric Asthma, Allergy & Immunology. Doi:10.1089/pai.2009.0017.