Allergie aux fruits à coque chez l’enfant : quelle prise en charge en pratique

Tree nuts are plant allergens frequently involved in allergic reactions to food in children. Among them, cashew, walnut, hazelnut, pistachio and almond are the most implicated, with sometimes anaphylactic reactions. The diagnosis of an allergy to nuts is simple and is based on history, skin tests, and biological assessment (specific IgE, molecular allergology). Cross-reactivity should be searched, between nuts but also with peanuts and sesame. It should be possible not to perform an oral food challenge in all cases to explore these potential cross-reactivities. Oral immunotherapy protocols, especially for hazelnuts, cashews, pistachio and walnuts are being developed.