Clinical characterization
A total of 150 clinical records of children with suspected TN and/or peanut allergy were reviewed, of which 52 were excluded (38 for exclusion of nut allergy and 14 for incomplete data). As a result, 98 patients were included in this study, of whom 63 were male (64%).
The majority of patients (n=86, 88%) had a concomitant allergic disorder: 76 (78%) allergic rhinoconjunctivitis, 50 (51%) asthma, 45 (46%) another food allergy, including 30 (31%) with egg allergy, and 43 (44%) eczema. Thirty-nine (40%) patients had a family history of allergy (Table 1) .
Major culprit nuts were peanut (n= 62, 63%), hazelnut (n=58, 59%), walnut (n=52, 53%), almond (n=37, 38%) and cashew (n=31, 32%), followed by chestnut (n=19, 19%), pistachio (n=18, 18%) and pine nut (n=6, 6%). Eighty-eight (86%) patients reported a single-nut reaction, although only 31 (32%) were monosensitized after allergological investigation was carried out (16 to peanut, 7 to walnut, 4 to cashew, 2 to hazelnut and 2 to pine nut). In 96 (98%), symptoms appeared within 30 minutes after exposure. The index reaction occurred before 2 years in 26% of patients and in the majority (59%) before the 5 years.(Table 1) .