{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:11:30Z","timestamp":1790982690813,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T00:00:00Z","timestamp":1512432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Ambiguities exist regarding the diagnosis of tree\u2010nut allergy, necessitating either their elimination or the performance of oral food challenges (\n                      <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content>\n                      s).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To examine the coincidences of allergies among tree\u2010nuts and improve diagnostic testing to minimize the need for\n                      <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010three patients prospectively evaluated for walnut, pecan, cashew, pistachio, hazelnut, and almond allergy. A history of previous reactions was obtained, and standardized skin prick tests (\n                      <jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>\n                      s) using finely ground tree\u2010nut solution and basophil activation tests (\n                      <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content>\n                      ) were performed. Patients underwent\n                      <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content>\n                      for each tree\u2010nut they eliminated and to which a reaction in the previous 2\u00a0years was not documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      While most patients were sensitized to 5\u20106 tree\u2010nuts, over 50% were allergic to only 1\u20102 tree\u2010nuts. The highest rate of allergy in sensitized patients was observed for walnut (74.6%) and cashew (65.6%). The rate of co\u2010allergy for most tree\u2010nuts was &lt;30%. Two\u2010thirds of walnut\u2010 and cashew\u2010allergic patients were also allergic to pecan and pistachio, respectively, while all pecan\u2010 and pistachio\u2010allergic patients were allergic to walnut and cashew, respectively. Receiver\u2010operating characteristic analysis for\n                      <jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content>\n                      was tree\u2010nut dependent and yielded area under the curve (\n                      <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>\n                      ) values ranging from 0.75 to 0.94. Knowledge of coincident allergies in these pairs along with the combination of\n                      <jats:styled-content style=\"fixed-case\">SPT<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">BAT<\/jats:styled-content>\n                      correctly distinguished allergic from tolerant patients for walnut (87%), pecan (66%), cashew (71%), and pistachio (79%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The data presented here should assist in differentiating between allergic and tolerant patients, decrease the need for\n                      <jats:styled-content style=\"fixed-case\">OFC<\/jats:styled-content>\n                      , and allow for appropriate elimination recommendations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.13353","type":"journal-article","created":{"date-parts":[[2017,11,11]],"date-time":"2017-11-11T07:32:44Z","timestamp":1510385564000},"page":"593-601","source":"Crossref","is-referenced-by-count":112,"title":["<scp>NUT<\/scp>\n                    Co Reactivity \u2010 ACquiring Knowledge for Elimination Recommendations (NUT CRACKER) study"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8157-8143","authenticated-orcid":false,"given":"A.","family":"Elizur","sequence":"first","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"},{"name":"Department of Pediatrics Sackler Faculty of Medicine Tel Aviv University Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Y.","family":"Appel","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4377-472X","authenticated-orcid":false,"given":"L.","family":"Nachshon","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. B.","family":"Levy","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Epstein\u2010Rigbi","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Golobov","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Institute of Allergy, Immunology and Pediatric Pulmonology Assaf\u2010Harofeh Medical Center Zerifin 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