Particularities in a Child With Cashew Nut Allergy

Food allergy affects many young children and tree nut allergy is accountable for a large number of severe, life-threatening anaphylactic reactions. Cross-reactivity can occur not only with foods that are in the same biological family but also between certain fruits or vegetables and latex (latex-fruit syndrome). We present the case of a previous healthy 5-year-old girl referred to Pediatric/Allergology Consultation after an episode of sialorrhea, perioral urticarial rash, tongue swelling, and immediate vomiting after oral contact with cashew nut. Investigation revealed the following: positive skin prick test to walnut and positive specific IgE for cashew nut, walnut, hazelnut, and almond. ImmunoCAP ISAC was positive for storage proteins of walnut and hazelnut (Jug r 1 e Cor a 9) and for a specific allergen of latex (Hev b 3). It is interesting that anaphylaxis was the first manifestation of allergy in a healthy child. Also, we emphasize the importance to latex sensitization with potential future clinical relevance and the sensitization to Hev b 3, which is not documented to be involved in cross-reactivity phenomena/latex-fruit syndrome or present in an otherwise healthy child.