Skip to main content


  • Poster presentation
  • Open Access

Case Report: Revaluation of a previously diagnosed hazelnut allergy with component resolved diagnosis (CRD)

  • 1,
  • 2,
  • 3 and
  • 3
Clinical and Translational Allergy20144 (Suppl 2) :P39

  • Published:


  • Adrenaline
  • Clinical History
  • Food Allergy
  • Correct Diagnosis
  • Skin Prick Test


We report a case of an eleven years old girl who was referred to our Allergy Outpatient Clinic for the revaluation of a hazelnut allergy. During her infancy she was successfully desensitised to milk and egg. Afterward she had been followed by another Allergy Unit where, according to skin prick test and specific IgE dosage, it had been suggested to strictly avoid peanut and all treenuts, although clinical history was not suggestive of treenuts allergy. She was also provided with an auto-injectable adrenaline, due to the high risk of severe reactions to treenuts. No oral provocation test was performed to validate diagnosis and adrenaline prescription.

Methods and Results

At her first visit in our Allergy Outpatient Clinic, the girl's mother showed us an ISAC (Immuno Solid-phase Allergen Chip) test, suggested by the colleague who performed the specific IgE dosage to better clarify the allergological results. On this test, a moderate positivity to dust mites, hazel, birch and grass pollen, a moderate positivity to Jugr3 and only a mild positivity to Cora1 were identified. All other peanuts and treenuts allergens were negative. A prick test for hazel pollen (positive, 5 mm) was performed; hazelnut extract , hazelnut with prick-by-prick method all resulted negative. Therefore an oral provocation test was performed with hazelnut and no immediate reactions were observed. In the following days she ate hazelnut without any symptoms.


In this case-report we highlight the important role of CRD in the diagnosis of hazelnut allergy. Moreover, we underline the importance of a correct diagnosis of food allergy which has to rely not only on specific IgE dosage or skin prick test, but should be confirmed by an oral provocation test.

Authors’ Affiliations

Pediatric Department, Hospital of Palmanova, A.S.S. 5 "Bassa Friulana", Via Natisone 1, Palmanova, 33057, Italy
Pediatric Department, Hospital of Palmanova, A.S.S. 5 "BAssa Friulana", Palmanova, Italy
Azienda Ospedaliero-Universitaria di Udine Diagnostic Allergology and ImmunoPathology Departm, Udine, Italy


© Saretta et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.