Early Introduction and Other Characteristics in Children With Suspected Severe Peanut or Tree Nut Allergy: Finnish Cohort

AIM: Peanut and tree nut allergies are leading causes of food-induced anaphylaxis in children. We aimed to examine early introduction and allergic characteristics in children with suspected severe peanut and/or tree nut allergy. METHODS: Children aged 3-16 years with suspected severe peanut and/or tree nut allergy were recruited from Tampere University Hospital, Finland. Eligibility was based on a history of anaphylaxis and/or elevated specific immunoglobulin E (sIgE) to high-risk allergenic components. Data were collected through structured, physician-led interviews with participants and their caregivers. RESULTS: The study included 103 children (mean age 7.2 ± 3.0 years), of whom 47.6% had a history of anaphylaxis. Early nut introduction (< 6 months) did not occur at all among the participants. Additionally, nut introduction before 12 months was rare (< 2%). Peanut and cashew were the most introduced nuts and the most frequent anaphylaxis triggers. Parental food allergy was significantly more common among children without anaphylaxis compared to those with confirmed anaphylaxis (38.5% vs. 18.4%; p = 0.035). CONCLUSION: Early nut introduction was absent among children with suspected severe nut allergy, regardless of anaphylaxis history. Parental food allergy was more prevalent in children without anaphylaxis, suggesting it is not a reliable predictor of severe allergic reactions.