Oral food challenge with a mix of tree nuts to partially liberalize the diet in pediatric IgE-mediated tree nut allergy

Introduction: In selected cases of IgE-mediated tree nut allergy (IMTNA), a specific type of tree nuts (TN) must be avoided, and other specific types could be reintroduced into the children’s diet. The risk of allergic reactions and fear of the parents not being allowed to reintroduce these types of specific TN at home necessitate multiple oral food challenges. Material and Methods: Retrospective study to evaluate the efficacy of a chosen oral mixed nuts challenge (OMNC) to assess the tolerance to specific TN in children with IMTNA following an exclusion diet for all types of TN. Results: Eight children were selected, and all passed an OMNC using a chosen mix of TN. Discussion: OMNC avoids multiple challenges, saves time, reduces costs, and positively impacts the psychosocial and nutritional context. Conclusions: Performing an OMNC in low-risk allergic children seems a safe and effective procedure to rule out IMTNA to specific types of TN and liberalise children’s diet.