Almond allergy tests in 400 children: most passed
What it found
In 400 children who had an almond food challenge, 375 passed and 16 failed.
Only 2 children needed epinephrine.
What they found
Studies in people
Pass rate
Of 400 children who had an almond food challenge, 375 passed (93.8%), 16 failed (4.0%) and 9 were indeterminate (2%).
Test results and failure
Children who failed had higher almond sIgE (2.54 kU A /L) and larger skin prick test wheals (5.0 mm) than those who passed (1.41 kU A /L and 3.23 mm).
Pass rate at higher levels
Even with sIgE up to 10 kU A /L and skin prick test wheal size up to 5 mm, more than 95% of patients still passed the challenge.
Symptoms in reactors
Among children who reacted, itching was the most common symptom. Only 2 children had reactions that needed epinephrine.
No demographic differences
There was no difference in demographics or allergic comorbidities between children who passed and those who failed.
What the authors conclude
“Among patients in our cohort, the probability of passing an almond OFC was 94%.”
Also in their conclusions
- They say the probability of passing an almond oral food challenge in their group was 94%.
- They note that although higher almond sIgE and larger skin prick test wheals were linked to challenge failure, the pass rate stayed above 95% for sIgE up to 10 kU A /L and wheal size up to 5 mm.
- They state that anaphylaxis was uncommon among those who reacted, and their data support that outpatient almond challenges are safe for select patients.
How it was done
Almond allergy is hard to diagnose because test results are often falsely positive. Getting the diagnosis right matters because almond is a source of nutrition and milk products for children with other food allergies.
They reviewed all almond oral food challenges done at their pediatric outpatient practice between October 2015 and July 2017. They looked at 400 patients and collected dosing, reactions, treatments, demographic, clinical and laboratory data.
What it can’t tell you
- We summarised it from the abstract only.
- This was a review of challenges at one practice, so the results may not apply to all children.
- It cannot show what would happen in children who were not selected for an outpatient challenge.
Who paid
- Authors work at
- Elliot and Roslyn Jaffe Food Allergy Institute, New York
The paper
- Title
- Review of 400 consecutive oral food challenges to almond
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Baker MG, Kattan JD (2019). Review of 400 consecutive oral food challenges to almond. Annals of allergy, asthma & immunology. doi:10.1016/j.anai.2018.10.025PubMed 30414467DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error