Weinberger Tamar, Sicherer Scott
The Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Asthma Allergy. 2018 Mar 26;11:41-51. doi: 10.2147/JAA.S141636. eCollection 2018.
Tree nut (TN) allergy is common and often severe. It has become an important health concern as availability and consumption have increased. Prevalence varies by age and geographic region and appears to have increased in children. Accidental ingestion of TNs is common. Unfortunately, there is a lower likelihood of resolution of TN allergy, roughly 10%. TN-specific skin tests and serum immunoglobulin E levels can help aid in the diagnosis of TN allergy, but a careful medical history is important because a positive test in isolation is not typically diagnostic. Component-resolved diagnostic tests are being increasingly utilized and may improve accuracy. Management consists of strict avoidance of the causal nut(s) and prompt treatment of symptoms upon accidental exposure. A specific consideration with regard to the management of TN allergy is the decision to avoid all TNs or only the TNs to which a patient is clinically allergic. There are currently no data on the primary or secondary prevention of TN allergy. Treatment strategies are being evaluated.
树坚果（TN）过敏很常见，且往往较为严重。随着其可得性和消费量的增加，它已成为一个重要的健康问题。患病率因年龄和地理区域而异，且在儿童中似乎有所上升。意外摄入TN很常见。不幸的是，TN过敏缓解的可能性较低，约为10%。TN特异性皮肤试验和血清免疫球蛋白E水平有助于辅助诊断TN过敏，但详细的病史很重要，因为单独的阳性试验通常不能确诊。成分分辨诊断试验的使用越来越多，可能会提高诊断准确性。管理措施包括严格避免食用引发过敏的坚果，并在意外接触后及时治疗症状。关于TN过敏管理的一个特殊考虑是决定避免食用所有TN，还是仅避免患者临床上过敏的TN。目前尚无关于TN过敏一级或二级预防的数据。正在评估治疗策略。
