SEARCHNARRATIVE_REVIEWimmunology, internal medicine

narrative_review·immunology, internal medicine, clinical nutrition, clinical trial·PMC10047188

Natural History of Hazelnut Allergy and Current Approach to Its Diagnosis and Treatment

Children · 5 authors, 4 centres

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TL;DR

This narrative review summarizes the natural history, diagnosis, and management of hazelnut allergy, highlighting that hazelnut allergy is the most prevalent tree nut allergy in Europe and often persists lifelong.

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This narrative review synthesizes current evidence on the natural history, diagnosis, and treatment of hazelnut allergy. Allergy to hazelnut, like other tree nut allergies, tends to persist throughout life, with only a minority improving during adolescence. Oral allergen immunotherapy (AIT), alone or combined with monoclonal antibodies, is described as a promising approach to increase tolerance and reduce severity of accidental reactions, though evidence remains limited with no standardized protocol and no long-term tolerance data.

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narrative_review

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immunology

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ORIGINAL PAPER

PMC10047188

Natural History of Hazelnut Allergy and Current Approach to Its Diagnosis and Treatment

Children

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ABSTRACT

Hazelnut allergy is the most prevalent type of nut allergy in Europe, with symptoms that can range from mild, such as hives and itching, to severe, such as anaphylaxis, particularly in patients who are sensitized to highly stable allergens, such as storage proteins. Compared to other types of food allergies, allergies to tree nuts, including hazelnuts, tend to persist throughout life. Although symptoms can appear in early childhood, they often continue into adulthood, with a minority of cases improving during adolescence. Currently, there is no curative treatment available for hazelnut allergy, and patients must adhere to a restrictive diet and carry autoinjective epinephrine. However, oral allergen immunotherapy (AIT) is a promising treatment option. Patients can be categorized based on their risk for severe reactions using various clinical, in vivo, and in vitro tests, including component-resolved diagnosis and oral food challenge. This review aims to provide an overview of the current knowledge of the natural history of hazelnut allergy and new approaches for its diagnosis and management.

CITATION EXPORT

Arianna Giannetti, Alessandro Ruggi, Giampaolo Ricci et al.. Natural History of Hazelnut Allergy and Current Approach to Its Diagnosis and Treatment. Children. (2023). https://doi.org/10.3390/children10030585

AUTHORS

5 · 4 CENTRES

Arianna Giannetti, Alessandro Ruggi, Giampaolo Ricci, Giuliana Giannì, Carlo Caffarelli

1Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
3Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
4Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy

EDITOR / REVIEWER

Russell Hopp