{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:15:11Z","timestamp":1761862511376},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,1,20]],"date-time":"2006-01-20T00:00:00Z","timestamp":1137715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Background\n\t\t\t\t\t<\/jats:bold> Allergy to Brazil nut is a relatively common nut allergy and can be fatal. However, the evidence is lacking regarding the best approach to its diagnosis.<\/jats:p><jats:p><jats:bold>Objective\n\t\t\t\t\t<\/jats:bold> We sought to determine the relative merits of history, skin prick testing, measurement of serum\u2010specific IgE and challenge in the diagnosis of Brazil nut allergy.<\/jats:p><jats:p><jats:bold>Methods\n\t\t\t\t\t<\/jats:bold> Fifty\u2010six children and adults with a history of an allergic reaction to Brazil nut or evidence of sensitization were investigated by questionnaire (<jats:italic>n<\/jats:italic>=56), skin prick tests (SPTs) (<jats:italic>n<\/jats:italic>=53), measurement of serum\u2010specific IgE to Brazil nut (<jats:italic>n<\/jats:italic>=54) and double\u2010blind, placebo\u2010controlled labial, and if necessary oral, challenges (<jats:italic>n<\/jats:italic>=19).<\/jats:p><jats:p><jats:bold>Results\n\t\t\t\t\t<\/jats:bold> Brazil nut allergy occurred in highly atopic individuals of any age with a strong family history of atopy. In 24 of 56 (43%), the history of an immediate reaction was sufficient to make a diagnosis with confidence and an oral challenge was considered unsafe. Of the 19 subjects undertaking the \u2018gold standard\u2019 test of a double\u2010blind, placebo\u2010controlled, food challenge, all six subjects with a SPT of at least 6\u2003mm had a positive challenge and all three subjects with a SPT of 0\u2003mm had a negative challenge. In the remaining 10 (53%) subjects, where SPT was between 1 and 5\u2003mm and serum\u2010specific IgE was less than 3.5\u2003kU\/L, an oral challenge was performed resulting in three positive and seven negative challenges.<\/jats:p><jats:p><jats:bold>Conclusion\n\t\t\t\t\t<\/jats:bold> A combination of history, SPT and serum\u2010specific IgE was adequate in achieving a diagnosis in the majority (77%) patients with suspected Brazil nut allergy. However, a doubtful history with SPT between 1 and 5\u2003mm, or a serum\u2010specific IgE less than 3.5\u2003kU\/L may require an oral challenge to help determine the risk of a Brazil nut allergic reaction.<\/jats:p>","DOI":"10.1111\/j.1365-2222.2006.02426.x","type":"journal-article","created":{"date-parts":[[2006,1,20]],"date-time":"2006-01-20T17:55:14Z","timestamp":1137779714000},"page":"226-232","source":"Crossref","is-referenced-by-count":19,"title":["The diagnosis of Brazil nut allergy using history, skin prick tests, serum\u2010specific immunoglobulin E and food challenges"],"prefix":"10.1111","volume":"36","author":[{"given":"S.","family":"Ridout","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Matthews","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Gant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Twiselton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Dean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. H.","family":"Arshad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,1,20]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"1074","article-title":"Clinical study of peanut and tree nut allergy in 62 consecutive patients","volume":"312","author":"Ewan PW.","year":"1996","journal-title":"new features and associations"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1996.tb00537.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)90837-8"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.1999.00981.x"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(89)90103-6"},{"key":"e_1_2_7_7_2","first-page":"528","article-title":"Peanut allergy in relation to hereditary, maternal diet, and other atopic diseases","volume":"313","author":"Hourihane J O'B","year":"1996","journal-title":"results of a questionnaire survey, skin prick testing, and food challenges"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(97)70133-7"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.1997.tb00141.x"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.1998.00370.x"},{"key":"e_1_2_7_11_2","first-page":"226","article-title":"Food allergy","volume":"10","author":"Sicherer SH.","year":"1999","journal-title":"when and how to perform oral food challenges"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.1999.00768.x"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.80.2.175"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7140.1271"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(84)90083-6"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1997.tb01190.x"},{"key":"e_1_2_7_17_2","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1001\/jama.1988.03410100140041","article-title":"Fatal food\u2010induced anaphylaxis","volume":"260","author":"Yunginger JW","year":"1998","journal-title":"JAMA"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199208063270603"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00864.x"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2222.2000.00928.x"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(98)70341-0"},{"key":"e_1_2_7_22_2","article-title":"Allergens from Brazil nut","volume":"25","author":"Bartolome B","year":"1997","journal-title":"immunochemical characterisation"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199603143341103"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2000.104941"},{"key":"e_1_2_7_25_2","first-page":"1195","article-title":"Peanut allergy","volume":"114","author":"Fleischer DM","year":"2004","journal-title":"recurrence and its management"},{"key":"e_1_2_7_26_2","first-page":"1046","article-title":"Thresholds of clinical reactivity to milk, egg, peanut and sesame in immunoglobulin E\u2010dependent allergies","volume":"33","author":"Morisset M","year":"2003","journal-title":"evaluation by double-blind or single-blind placebo-controlled oral challenges"}],"container-title":["Clinical &amp; Experimental Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2222.2006.02426.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2222.2006.02426.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T09:17:32Z","timestamp":1697188652000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2222.2006.02426.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1,20]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2006,2]]}},"alternative-id":["10.1111\/j.1365-2222.2006.02426.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2222.2006.02426.x","archive":["Portico"],"relation":{},"ISSN":["0954-7894","1365-2222"],"issn-type":[{"value":"0954-7894","type":"print"},{"value":"1365-2222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1,20]]}}}