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Don't avoid all nuts--advice for patients with nut allergies.

Patients with a peanut or tree nut allergy should not be advised to avoid all nuts--so says the first single guidance on managing and preventing nut allergy. The guideline was drawn up by the British Society for Allergy and Clinical Immunology (BSACI) and states that although complete nut avoidance is the safest approach, this is difficult in the real world and can lead to a severely restricted diet. The advice is that patients can carry on eating nuts that they know are safe at home, but should avoid nuts when out because of the risk of cross-contamination.

Nut allergy is common, affecting at least one in 50 children and one in 200 adults. Most patients do not outgrow the allergy. Because most patients are looked after by health professionals with no formal training in allergy, they receive inconsistent care and advice.

The BSACI guidelines were developed over the past 5 years and state that all patients should have a comprehensive management plan, including advice on avoiding nuts, recognising individual nuts, treating allergic reactions and training in using adrenaline self-injectors.

Introducing peanuts early in the weaning diets of infants at high risk of peanut allergy can prevent the allergy from developing, and there is no evidence to support the delayed introduction of peanuts into an infant's diet.

Stiefel G, Anagnostou K, Boyle RJ, et al. BSACI guideline for the diagnosis and management of peanut and tree nut allergy. Clin Exp Allergy 2017;357:719-739.

B Farham


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Title Annotation:30 days in medicine
Author:Farham, B.
Publication:South African Medical Journal
Article Type:Author abstract
Date:Jul 1, 2017
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