Cashew nut allergy tests and severe reactions in 66 patients
What it found
In 66 people tested with cashew nuts, 12 had a positive result and 5 of those 12 had a severe allergic reaction.
A past immediate reaction to cashew nuts and high cashew-specific IgE levels were linked to a positive test.
What they found
Studies in people
Positive challenge rate
Twelve of the 66 patients (18.2%) had a positive oral food challenge result.
Past reaction and failure
Six of 8 patients (75%) with a history of an immediate reaction to cashew nuts failed the oral food challenge.
Severe reactions
Five of the 12 patients (42%) with a positive challenge had a severe allergic reaction called anaphylaxis.
Risk factors
A history of an immediate reaction to cashew nuts and cashew-specific IgE levels were significantly different between patients with a positive or negative challenge result.
IgE threshold
Among patients without a previous immediate reaction to cashew nuts, the 95% positive predictive value for the cashew-specific IgE level for a positive challenge result was 66.1 kUA/L.
What the authors conclude
- They say a history of an immediate reaction to cashew nuts and high cashew-specific IgE were risk factors for a positive oral food challenge result.
- They note that the number of positive challenge results was relatively low, but there was a high probability of anaphylaxis.
- They advise considering the indication of oral food challenge carefully for patients with a history of immediate reactions to cashew nuts and avoiding it for patients without such a history whose cashew-specific IgE values are above 66.1 kUA/L.
How it was done
Cashew nuts can cause severe allergic reactions, but little has been reported about the details of cashew nut oral food challenges.
They measured cashew-specific IgE levels for 1 year in 66 patients who had an oral food challenge with more than 3 g of cashew nuts, for diagnosis or to confirm tolerance, between June 2006 and August 2014. They looked back at the challenge results and patient backgrounds.
What it can’t tell you
- We summarised it from the abstract only.
- This was a look back at past records, so it can show links but not prove cause and effect.
- The results come from 66 patients at one time and place, so they may not apply to everyone.
Who paid
- Authors work at
- Sagamihara National Hospital, Japan
The paper
- Title
- Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Inoue T, Ogura K, Takahashi K, et al (2018). Risk Factors and Clinical Features in Cashew Nut Oral Food Challenges. International archives of allergy and immunology. doi:10.1159/000486120PubMed 29342459DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error