Cashew nut allergy

[BuffaloFeathers]

My almost two year old ds had a severe allergic reaction today probably to cashew though I can't be entirely sure. He was fully covered in hives, facial swelling, vomitting, etc. Acc to the doctor halfway between allergic reaction and anaphylaxis. It's totally come out of the blue. He's been having peanut products with no problems whatsoever. In fact he almost daily has peanut butter but I am not actually sure if he's ever had other nuts

Does anyone have any experience with cashew allergy? I've googled it a bit and it doesn't look promising. Apparently cashew allergies tend to be severe, are more commonly associated with anaphylaxis and kids rarely grow out of them. For those with personal experience has this been true for you?

Should we avoid all tree nuts?

Also, is there a link between asthma and cashew allergy? (There might be acc to some studies but I'd like to know avout people's experience.) He has a lot of episodes of viral induced wheezing and also gets wheezy with dust or other small particles. We've been told there is a good possibility he will turn out to have asthma but he's too young to be tested.

Yes, cashew nut allergy here too. Take it that there is also a pistachio allergy, known as the evil twin. It's life-long so far as I know and you will need TWO adrenaline pens with the child all the time. I always carry Piriton too as reaction can happen on skin from touch alone. Anaphylaxis UK is a great website with lots of resources. You should get fast-tracked to your paediatric allergy clinic for further testing but be aware that a reaction only takes place from the second exposure. It is also possible that subsequent reactions are more serious. We avoid all tree nuts as a family, so serious are the consequences. Make sure you get a trainer pen too for yourselves to practice and anyone else who may care for the child. There is also a sibling with asthma, don't know about a specific link but eczema, asthma and allergy are closely related. Happy to answer any questions you might have if I can help.

We have cashew nut allergy in the family too. Also pistachio- agree with poster above- get allergy test done to see the level of reaction. I was told skin prick test is more specific than blood but try to get both done. Peanut is a legume so not in the same category. We avoid all nuts. And sesame seeds (had reaction to hummus and had skin prick test). Has 2 Epipens. Hope your child is able to stay safe. It is a worry as it could be lifelong.

We're the walnut, pecan and hazelnut family! Thankfully not very severe. If we can get a few antihistamines into DD in time we avoid the worst of it.

I do say that it's massively better to be allergic to the expensive nuts than the cheap ones (peanuts) because accidental exposure is less common.

My 2 year old is allergic to cashew, skin test showed pistachio too. He was given epipens and we are under an allergy clinic. Under their guidance we introduced peanut, hazelnut, almond, walnut and Brazil nut. His skin test showed a mild reaction to peanut but he’s been able to have peanut and the others listed without incident and now we make sure he has them a few times a week to prevent him developing more allergies. All I can say is make sure you check all ingredients as cashew is found in places you wouldn’t expect. Check them every time you buy as recently some of our favourite pestos have quietly replaced pine nuts with cashew. We now make our own x

Just remembered, pink peppercorn is also in the same family. We are avoiding for now and he will be tested at the allergy clinic next time.

not had pecan yet

Thanks so much for the replies. Can I ask how you got referred to the allergy clinic? At a n e I was told they only refer if you presented with an anaphylactic reaction. The doctor suggested that if he has repeated episodes of allergic reaction we should go to our GP and they would be able to refer him to the allergy clinic.

I'm really worried that the next time it will be anaphylactic. How long do you have onc
e the swelling or breathing difficulties start? We obviously don't have an epi pen. Would we make it to the hospital at all?

I've read about cross reactivity with pistachio. I wonder is he more likely to be allergic to all tree nuts? We noticed a few things that almond milk may have given him a rash (he was off cows milk as that gave him an upset stomach). I'm not entirely sure it was the almond milk though just as I can't be 100% it was cashew.

Do allergies get worse? I feel so bad for him.

My youngest dd has just had her skin prick test after a severe reaction. We had to wait eighteen months. I'd look at going private if you are worried about waiting.

My oldest is anaphylactic to peanuts. It is scary but you do get used to it. It just becomes a part of your life and eventually they take over the management of it, the reading the packets and making sure they have the medication they need.

The first time my dd went out to a nightclub my dh said as she was leaving

'have you got everything?'

And she said

'Lipgloss, phone, drugs. Yes Byeee'
Leaving him standing agog till I reminded him she meant piriton.

My cousins child has this - cashew and pistachio together

Watch out for pesto - very often has pine nuts substituted with Cashews

Do go to your GP for an allergy clinic referral, you can ask them to mark it as urgent but lots and lots will also marked as urgent but do this because it's a start. In the meantime don't give him any nuts - wait until you have advice from a specialist. The skin prick tests and even blood tests are a guide, they are helpful to a degree. The allergy can change within the group of foods, it's the reactions that tell you most and remember it's after the second exposure, which matters when a child is young enough not to have consumed less usual foods.

I think there is a corresponding likelihood of an allergy to stings/bites. My son reacts very badly to them and to heat but not anaphylaxis. It's worth reading about histamine and low histamine diets if there is asthma/eczema but not everyone does.

Make sure everyone who looks after him keeps him away from nuts. Keep Piriton in his bag and let everyone know the signs and response of anaphylaxis. Call Anaphylaxis UK for advice, it was started by a parent. If you have the means to go private to get the Junior Epi-pens I would do do, it shouldn't have to be this way but it is now, there may still be a wait.

It's a scary place to be right now but there will be support - you have to pursue it though. I don't think you get to the point of blasé about it but it becomes very normal at some point.

Ask us all if you need further information or have questions.

Thanks for the tip on pesto. He hasn't had yet pesto but it's something I'll look out for. We are in for a lot of label reading I think. I kind of grieve a little bit the ease with which I thought he could just eat food. Does that make sense? I know it sounds stupid but I'm just sad that he's got a life time of checking labels and ingredients in front of him. From what I've read cashew nut allergy is unlikely to be grown out of.

The thing is we don't even know if it was cashew. It seems likely since I don't think he had anything particularly uncommon (even 😜as second exposure) that day and he had four pieces of this cashew sweet kind of thing in the hours before his reaction.

So should we avoid all tree nuts now or just cashew and pistachios? At A n E they just asked me to avoid cashew nuts. It is a weird coincidence that almond milk seemed to give him a rash as well (though again can't be sure about that).

I came on to say avoid pink peppercorns as they are part of the cashew family and pleased to see someone else knew too. I'm a chef and find it worrying that there is no allergy warning on anything about pink peppercorns and few people are aware of this.

It's interesting that you say that. We went on holiday recently to.somewhere quite warm and he had a terrible heat rash and also his mosquito bites took quite long to heal.

I feel like everything is slowly building up a picture of an over zealous immune system: Wheezing (and suspected asthma), strong reaction to heat and insect bites, possible tree nut allergy. What else can we expect? What else will he struggle with?

I guess the first thing we should do is to try to get an allergy test done privately so we can stop guessing if it was the cashew or not.

Sorry for the sideline question but lots of people mention Piriton specifically - is it faster-acting than other types? I don’t usually have it in as it makes me drowsy but I have oral allergy syndrome - eg stoned fruits and hazelnuts - tho I don’t need an epipen so not severe.

Another question:

I was 43 when D's was born and dh is a similar age. Could that be the reason why he is suffering from all these things? We don't have asthma or severe allergies in the family so I'm wondering what could have caused it.

As far as I know that young children in the UK can only take piriton. Older kids and adults can take certirizine but I think you need to be at least two years old.

I think certirizine works quicker or is slightly stronger but I'm not sure.

Or could it be because he was combination fed right from a few days old? I did breastfeed him for about a year but supplemented with formula and I suspect he probably had more formula than breast milk.

I was just a few years younger when I had dd it she was exclusively breastfed and never had the same problems as him. Apart from a cold she is never ill either whereas he seems to catch everything that is going at nursery and easily gets a very high temperature with every little cold.

As far as I know that young children in the UK can only take piriton. Older kids and adults can take certirizine but I think you need to be at least two years old.

I think certirizine works quicker or is slightly stronger but I'm not sure.

Thank you. And I hope you find the answers you need and it all works out ok.

Re your question about what to expect, just remember that allergy, asthma and eczema are the same family. Get the wheeze checked out, inhalers are available for little ones if this seems necessary. It could be a reaction to an airborne allergen - dust, pollen, etc. My son gets hives when he cleans his room but tested negative for dust mite allergy, like I said earlier it's the reactions that tell you the most not the tests. He got a lot of urticaria, croup and ear infections when young but this has lessened a lot with maturity. We all have different levels of immunity. Or it may be that your son's immune system is really busy under normal conditions fighting off various responses so there simply isn't enough protection when a virus comes around.

This may be as difficult as it gets. There may be simple explanations for things so far. It may become more complex. A symptom diary is a really good thing and photos/videos of anything visible.

Re Piriton, my son says he prefers this liquid (suitable from infant to adult) as he feels it makes a difference as soon as he can taste it in a way other brands/tablets don't. There are different anti-histamine meds for different things - Loratidine, Cyclizine and so on. Again, it may be trial and error to find what works best for the individual.

Write down exactly what he had to eat that day. Could come in handy when testing for allergies

Also, I am totally familiar with trying to find out why. You'll likely never know. It could be environmental. There's no allergy/asthma/eczema in our families either. None of your reasonings explain the size of the allergy issues world wide. I personally don't think this is a helpful road to go down.

Thanks for the reply. He has an inhaler and we need to use it quite frequently. We still end up in A nE about once every month when his wheezing can't be controlled with the inhaler. our GP has referred him to a pediatrician for this but I doubt we will get an appointment any time soon.

When we went on holiday he reacted very badly to the dust and pollution. We had to use his inhaler every day three times a day as his wheezing got really bad. An ent doctor we saw there also prescribed certirizine, which really seemed to help.

So if we do an allergy test can they test for nut allergy and also which particular tree nuts? Is the test not conclusive? I mean does it have a lot of false positives or worse, false negatives?

No, I know it's not especially since all of this can't be changed now but gosh I wish we didn't have this hanging over his head. I'm already super worried about him having asthma.

Will do. The only things I remember apart from cashew is all stuff he's had tons of times, bread, rice, potatoes, etc.

The only other thing he had that day that he's never had was butter made.from buffalo milk but he had very little of that and I don't think it's particularly allergenic though I guess you can be allergic to anything.

Another question: I read on another Mumsnet post (recommended by the "similar threads feature"..am I the only one that actually finds it quite useful??) About cross reactivity of cashew nuts with citrus fruit seeds. Is this a thing?

Also, I suppose you can't get an epi pen over the counter can you?

Cashew/pistachio nut allergy in my DD as well. She is fine with all other nuts. You need to get a referral to an allergist ASAP. If the NHS fobs you off, persist, and scrape together the money to get in privately if possible. Echo all other comments. This is not something you can manage on your own, but equally, once you know exactly what the allergy is, it will become much less scary. 2 epipens at all times, and religious reading of labels. Once you get into the habit it's really not as overwhelming as it seems right now. My DD also has eczema but no asthma. They all go hand in hand as PP said so you need to get a specialist to assess the specifics for your DC. Pesto, Indian food, Chinese food all often have hidden cashew. Also be vigilant at gelato places as there is usually pistachio flavour and the scoop used needs to be very carefully cleaned or, preferably, a separate scooper used for your child.