LOS ANGELES — Rare and mild allergic reactions were observed during open food challenges to almond, according to research presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
To determine immunoglobulin E-mediated almond hypersensitivity among oral food challenge outcomes, researcher Paul E. Hesterberg, MD, of Massachusetts General Hospital, and colleagues performed a retrospective analysis of 231 open food challenges to almond. Included in the oral food challenge were 239 patients (median age, 7.6 years; range, 11 months to 55 years). During the challenges, nursing flow and symptom score sheets indicating subjective and objective signs and symptoms were kept.
These data sheets, evaluated by Hesterberg and colleagues, showed that the median almond IgE was 0.6 kU/L (range, <0.35 to 81.9) and median skin prick test was 3 mm (range, 0-15). Negative skin testing and serum IgE to almond (double negative) was indicated in 59 patients (25%). A history of prior reaction to almond was prominent in 16 patients.
“Serum specific IgE testing was not associated with clinical reactivity to almond in this population,” Hesterberg told Healio.com/Allergy. “Serum skin prick test to almond was not significantly associated with clinical reactivity, although there was a trend indicating that evaluation with a larger sample size is necessary to confirm.”
Among the oral food challenge outcomes, 223 (92%) were passes, 13 (5%) were failures, and 6 (3%) were indeterminate. Median IgE to almond was 0.41 kU/L (6 with negative IgE), and median skin prick test was 5 mm (3 with negative skin prick tests) within the challenge failures. No statistical difference was found between challenge passes and failures based on prior history of almond reaction (6.7% of passes vs 7.7% of fails), or presence of almond sensitization (75% of passes vs. 77% of fails).
Antihistamines were prescribed for treatment alone in 77% — or 10 of 13 — of challenge failures. Cutaneous symptoms such as flushing, mild urticaria and pruritus remained mild.
“Clinical history of almond hypersensitivity was not associated with increased likelihood of reactivity during oral food challenge when compared with patients with no prior history. Clinical hypersensitivity to almond is rare overall and reactions tend to be mild in severity,” Hesterberg said. — by Alaina Tedesco
Reference: Hesterberg PE, et al. Abstract 410. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.
Disclosure: The researchers report no relevant financial disclosures.