Teuber Suzanne S, Comstock Sarah S, Sathe Shridhar K, Roux Kenneth H
Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, School of Medicine, One Shields Avenue, TB192, Davis, CA 95616, USA.
Curr Allergy Asthma Rep. 2003 Jan;3(1):54-61. doi: 10.1007/s11882-003-0013-x.
Tree nuts are clinically associated with severe immunoglobulin E-mediated systemic allergic reactions independent of pollen allergy and with reactions that are usually confined to the oral mucosa in patients with immunoglobulin E directed toward cross-reacting pollen allergens. The latter reactions can progress to severe and life-threatening episodes in some patients. Many patients with severe tree nut allergy are co-sensitized to peanut. Clinical studies on cross-reactivity between the tree nuts are few in number, but based on reports to date, avoidance of the other tree nuts once sensitivity is diagnosed appears prudent unless specific challenges are performed to ensure clinical tolerance. Even then, great care must be taken to avoid cross-contamination. As with other severe food allergies, a recurrent problem in clinical management is the failure of physicians to prescribe self-injectable epinephrine to patients who are at risk of anaphylaxis.
坚果在临床上与严重的免疫球蛋白E介导的全身过敏反应相关，这种反应与花粉过敏无关，并且在针对交叉反应性花粉过敏原产生免疫球蛋白E的患者中，反应通常局限于口腔黏膜。在某些患者中，后一种反应可能会发展为严重的、危及生命的发作。许多患有严重坚果过敏的患者对花生也产生了共同致敏。关于坚果之间交叉反应性的临床研究数量很少，但根据迄今为止的报告，一旦诊断出过敏，避免食用其他坚果似乎是谨慎的做法，除非进行特定的激发试验以确保临床耐受性。即便如此，也必须格外小心以避免交叉污染。与其他严重的食物过敏一样，临床管理中一个反复出现的问题是医生未能给有过敏反应风险的患者开出自用注射肾上腺素。
