Malanin et al. (1995) [105] reported one 8-year old girl who suffered from vomiting, hives, generalised urticaria and wheezing 15-20 minutes after ingestion of a pecan containing cookie
Yunginger (1988) [568] reported fatal anaphylaxis of a 16-year old male
Gillespie et al (1976) [342] reported urticaria, angioedema, asthma in a study of 18 patients allergic to tree nuts.
Note that more than 20 patients are reported as allergic to pecan (see below) but their symptoms are not described separately from those due to other tree nuts.
Skin Prick Test
Number of Studies:
1-5
Food/Type of allergen:
Pecan and a pecan containing cookie (Malanin et al. 1995 [105]).
Protocol:
(controls, definition of positive etc)
Prick-Prick, moistening the pecan with saline. 10 mM histamine dihydrochloride was the positive control.
Malanin et al. (1995) [105] found that the patient reacted only to the cookie or pecan nuts from the cookie (5x5mm) rather than to raw pecan.
IgE assay (by RAST, CAP etc)
Number of Studies:
1-5
Food/Type of allergen:
Malanin et al. (1995) [105] extracted fresh, heated and stored pecan nuts with 150 mM NaCl and 3 mM NaN3 (1:10, w/v) and coupled to CNBr-activated filter paper disks.
Sicherer et al. (1998) [517] used a commercial extract.
IgE protocol:
CAP
Number of Patients:
111
Summary of Results:
Sicherer et al. (1998) [517] report that 11/111 patients who reacted to pecan had a mean specific IgE of 18.3 kU/l while 10/111 peanut or tree nut allergic patients who had eaten pecan without a reaction had a mean pecan specific IgE of 1.6 kU/l.
Immunoblotting
Immunoblotting separation:
Immunoblotting is only described in a preliminary report (Teuber SS, Sathe SK, Roux KH, Peterson WR. J. Allergy Clin. Immunol. 105 (1), S424).
Immunoblotting detection method:
Immunoblotting results:
Oral provocation
Number of Studies:
0
Food used and oral provocation
vehicle
Blind?
Number of Patients?
Dose response
Symptoms
No oral provocation performed
IgE cross-reactivity and Polysensitisation
Sicherer et al. (1998) [517] report that pecan is the second most common tree nut allergy in peanut allergic patients after walnut (13 pecan allergic/54 tree nut allergic/102 patients). Roux et al. (2003) [694] and an abstract (Teuber SS, Sathe SK, Roux KH, Peterson WR. J. Allergy Clin. Immunol. 105 (1), S424) report that there is complete IgE cross reactivity by immunoblotting between pecan and walnut.
Other Clinical information
Many studies report allergy to "tree nuts". Allergy to pecan was the fourth most common of the tree nuts allergies reported by Sicherer et al. (2001) [826] with 9% of the 1667 nut allergic registrants reporting pecan allergy. Similarly Sicherer et al. (1998) [517] report 13/54 nut allergic patients as pecan allergic. However, the symptoms, described as 89% involved the skin (urticaria, angioedema), 52% the respiratory tract (wheezing, throat tightness, repetitive coughing, dyspnea), and 32% the gastrointestinal tract (vomiting, diarrhoea) were not associated with specific nuts. In the UK pecan may not be as common a source of tree nut allergy with Clark and Ewan (2003) [615] reporting 8/1000 patients showing their strongest reaction to pecan based on clinical history (however, the number of patients who tolerated pecan was not reported).
Malanin et al. (1995) [105] and Berrens (1996) [24] report a neo-allergen, which appears on storage (>2 weeks) of pecan nuts and products containing nuts. They suggested that a Maillard reaction product might be the allergen.
Reviews (1)
Roux KH, Teuber SS, Sathe SK.
Tree nut allergens. Int Arch Allergy Immunol. 131(4):234-244. 2003
PUBMED ID:
12915766
Clark AT, Ewan PW.
Interpretation of tests for nut allergy in one thousand patients, in relation to allergy or tolerance. Clin Exp Allergy 33(8):1041-1045. 2003
PUBMED ID:
12911776
Sicherer SH, Burkes AW, Sampson HA.
Clinical features of acute allergic reactions to peanut and tree nuts in children Pediatrics 102 1-6 1998
PUBMED ID:
9651458
Sicherer SH, Furlong TJ, Munoz-Furlong A, Burks AW, Sampson HA.
A voluntary registry for peanut and tree nut allergy: characteristics of the first 5149 registrants. J Allergy Clin Immunol. 108(1):128-32. 2001
PUBMED ID:
11447394
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