[Nut allergy - a difficult problem for the clinician]

Nuts belong to the most significant causes of food anaphylaxis in Finland. Diagnosis of nut allergy is complicated by the fact that for those having birch allergy, skin prick tests and serum tests yield a positive reaction for peanut and hazelnut without the nut causing the allergy reactions. For fear of anaphylaxis, avoidance of nuts on the basis of conventional tests measuring allergic sensitization leads to an unnecessary therapeutic diet. Attempts must be made to recognize patients for whom the ingestion of even minute doses of nuts may be life-threatening. For patients having severe symptoms, guidance counseling and first-aid medication are offered as a precaution for accidental exposure.