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Rudi, an 8-year old boy with a history of rhinoconjunctivitis during tree pollen season and asthma exacerbations during infections and exertion, comes to see you because he is now also experiencing itching in the mouth when eating hazelnuts. His mother is sensitized to tree nuts and is worried that Rudi is, too.
His healthcare professional conducts a full clinical history and physical examination and decides to test using specific IgE testing.
Tree pollen, peanut, tree nut and pet dander allergy
His previous healthcare professional recommended that Rudi strictly avoid peanut and tree nuts and use oral antihistamines during tree pollen season, as well as symptomatic treatment with inhalant long-acting ß2-agonists and corticosteroids.
|At 4 years SPT results|
Based on these results, his healthcare provider decides to perform testing with allergen components.
|ImmunoCAPTM results (kUA /l)|
These results, together with Rudi's case history and symptoms, may help his healthcare professional confirm the diagnosis.
|ImmunoCAP results (kUA /l)|
|Ara h 1||Allergen Component||0.2|
|Ara h 2||Allergen Component||4.3|
|Ara h 3||Allergen Component||<0.1|
|Ara h 8||Allergen Component||1.4|
|Ara h 9||Allergen Component||<0.1|
|Cor a 1||Allergen Component||12.8|
|Cor a 8||Allergen Component||<0.1|
|Cor a 9||Allergen Component||<0.1|
|Cor a 14||Allergen Component||<0.1|
Rudi’s sensitization to the peanut storage protein Ara h 2 shows that Rudi has an increased risk for severe reactions if eating peanuts.1 Strict avoidance of peanut is therefore recommended.
Rudi’s birch allergy gives rise to cross-reactivity with the PR-10 protein Cor a 1 in hazelnut, and the itching in Rudi’s mouth when eating hazelnuts may originate from the pollen-food allergy.2-4
Rudi’s sensitization to birch pollen is confirmed, continue with current medication.
Primary peanut allergy and birch allergy
Healthcare professional's management plan
Birch pollen, peanut and pollen-food allergy
Rudi is fit and well. His autoinjector technique is satisfactory.
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