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Vol. 48. Issue 4.
Pages 316-322 (July - August 2020)
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Vol. 48. Issue 4.
Pages 316-322 (July - August 2020)
Original Article
DOI: 10.1016/j.aller.2019.07.005
Phenotypical characterization of tree nuts and peanut allergies in east Mediterranean children
Pınar Gur Cetinkayaa, Betul Buyuktiryakia, Ozge Soyera, Umit Murat Sahinera, Cansın Sackesenb, Bulent Enis Sekerela,
Corresponding author

Corresponding author.
a Division of Pediatric Allergy and Asthma Unit, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Sıhhiye, Ankara, 06100 Turkey
b Division of Pediatric Allergy, Koc University School of Medicine, Istanbul, Turkey
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Figures (2)
Tables (4)
Table 1. Characterization of the study population (n=227).
Table 2a. Correlation between SPT wheal diameters of TNs and PN.
Table 2b. Correlation between sIgE of TNs and PN.
Table 3. Co-allergy rates between TNs/PN.
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The characteristics of tree nuts (TNs) and peanut (PN) allergies vary in different regions of the world. We aim to identify the characteristics of TNs/PN allergies in Turkish children.

Patients and Methods

A total of 227 children [4.8 (3.2–6.8) years] with TN and/or PN allergies were included. The phenotypical features of TNs/PN allergic children and the risk factors for multiple TNs/PN allergies were evaluated.


Allergy to TNs/PN developed at a median age of 12.0 (10.0–18.0) months. The most common TNs/PN responsible for food allergies were the hazelnut (63.9%) and the pistachio (54.6%). Of TNs/PN allergic children, 54.2% experienced reactions with at least two types of . Current ages 6–10 years [OR:2.455, 95% CI:1.255-4.852, p=0.009] and family history of atopy [OR:2.156, 95% CI:1.182–3.932, p=0.012] were the risk factors for multiple TNs/PN allergies. Most of the patients with cashew nut and pistachio allergies exhibited co-sensitization and co-allergy to both of these TNs/PN. Although the rarest TNs/PN allergy was seen with almond, the possibility of allergy to other TNs or PN was highly increased in the patients with almond allergy compared to other TNs/PN.


Children with TNs/PN allergy living in an East Mediterranean region differ from the counterparts living in Western countries by an earlier age of onset of the TNs/PN allergy symptoms, increasing possibility to have multiple TNs/PN allergy at older ages, and different spectrum of TN/PN allergies (hazelnut followed by pistachio/cashew) that all indicate the consumption habits which are important determinants of TN/PN allergy development.

Tree nuts


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