Anaphylaxis due to the ingestion of peanuts is a serious; common condition; known to both the general public and physicians. Recently; an increasing number of patients with an anaphylactic reaction after eating small amounts of cashew nuts have been reported. In three children; a boy aged 7 and two girls aged 9 and 10 years; respectively; with heterogeneous case histories involving allergic upper airway and conjunctival symptoms and constitutional eczema; allergy for cashew nuts was diagnosed in the first two and allergy for peanuts in the third. They were given dietary advice and an adrenaline auto-injector for emergencies. In most cases; a detailed food history; together with the demonstration of IgE against cashew nuts by means of serology or skin prick tests; are sufficient to establish the diagnosis. If the clinical relevance of a sensitisation to cashew nuts is unknown; a food provocation test may be necessary. The treatment consists of dietary intervention; and an adrenaline auto-injector is prescribed for a serious anaphylactic reaction. So far; three major allergens from the cashew nut (Anacardium occidentale) have been identified and purified.
