From: ALEX versus ISAC multiplex array in analyzing food allergy in atopic children
Patient (Sex M/F; age yr) | Food allergies (clinically relevant) | Inhalation allergies (clinically relevant) | Asthma | Eczema | Unexplained anaphylaxis in history | Possibly relevant extra results (negative and positive sensitizations) found by ALEX not present in ISAC | Sensitizations found by ALEX with unknown clinical relevance | Dietary modifications or extra challenge tests performed based on ALEX results |
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1 (M; 16) | Egg, peanut, nuts, coconut, legumes, wheat, seeds, carrot, banana, kiwi | Mites, trees, multiple animals | Yes | Yes | No | Highly positive; all sorts of nuts, legumes (except green bean), cereals incl. buckwheat and seeds Moderately positive: caraway, cricket, storage mite(Lep d 2) Negative: banana extract | Cricket, mealworm (low), caraway, fenugreek, poppy seeds, storage mites, lupin | No dietary modifications Optional: challenge test banana or green bean in future |
2 (M; 12) | Nuts | Trees, grass, multiple animals | No | No | Yes | Highly positive: all sorts nuts and seeds (except fenugreek) Moderate- highly positive: LTP proteins Act d 10 (kiwi), Mal d 3 (apple), Vit v 1 (grapes), Api g 2 (celery), Zea m 14 (corn). Buckwheat, chickpea extract, storage mites (Gly d 2, Lep d 2) | Storage mites Cor a 14 (hazelnut) Fag e 2 (buckwheat) (both negative in ISAC) | No dietary modifications Food challenge tests performed for poppy seeds and buckwheat: both negative |
3 (M;12) | Cow’s milk, nuts, certain legumes (except brown and green beans) | Mites, trees, grass, dog | Yes | No | Yes | Moderately positive: all legumes (except green bean), sunflower and poppy seeds, mustard, beef and pork Negative: extracts and components for pistachio- and macadamia nuts, components cashewnut (Ana o 2, Ana o 3) | Cricket, grasshopper, mealworm and buckwheat (low sensitizations), lupin, seeds incl. poppy seeds and fenugreek | No dietary modifications Optional: challenge test cashewnut / pistachio and macadamia nut in future |
4 (M: 15) | Nuts, sesame, bean sprouts, legumes (except brown and green beans), kiwi | Mites | Yes | Yes | No | Highly positive; all sorts of nuts, seeds incl. sesame and poppy seeds, buckwheat Moderately positive: caraway, anise, chickpeas Negative/very low: peas, lentils and green bean | Caraway, anise, buckwheat, poppy seeds | No dietary modifications Optional: challenge test peas or lentils in future |
5 (M; 7) | Cow’s milk, nuts, kiwi, fish Also avoids seafood | No clinical relevant | Yes | Yes | No | Highly positive; all sorts of nuts (except macadamia), all sorts of fish (parvalbumins), beef potato and mustard, storage mites (Aca s, Gly d 2, Lep d 2, Tyr p) Moderately positive: chickpeas, lentils, peas, buckwheat, lupin, sunflower, poppy and sesame seeds, beef, pork and rabbit Negative/very low: macadamia nut, all seafood species | Chickpeas, lentils, seeds incl. fenugreek, poppy seeds, mustard, buckwheat, lupin, rabbit meat, storage mites Jug r 1 (walnut; negative in ISAC) | Introducing seafood allowed Optional: challenge test macadamia nut in future |
6 (M; 13) | Peanut, nuts (except almond) | Mites, trees, grass, multiple animals | Yes | Yes | No | Highly positive; cashewnut, pistachio, pecan- and walnut Moderately positive: pear, storage mites (Gly d 2, Lep d 2) Negative: macadamia- and brazil nut and almond | Storage mites | No dietary modifications Optional: challenge test brazil or macadamia nut in future |
7 (F; 13) | Cow’s milk, egg, soy, hazelnut Avoids all nuts and fish | Mites, trees, grass, multiple animals | Yes | Yes | No | Moderate positive; tuna, carper and sword fish (parvalbumins), north sea shrimp (Troponin C), oyster, cashewnut and brazil nut extract (components negative), caraway and anise, cricket, grasshopper, mealworm, storage mites (Aca s, Tyr p, Lep d 2) Negative/very low: pecan- and walnut, macadamia and pistachio nut | North sea shrimp, fish, cricket, grasshopper, mealworm, storage mites, poppy seeds | No dietary modifications Optional: challenge test for any nut in future |
8 (M; 11) | Peanut, peas, white beans, bean sprouts, walnut and pecan nut, fish Also avoids seafood and big amounts of lentils and peas | Mites, trees, grass, multiple animals | Yes | Yes | No | Highly positive: All nuts (except almond and macadamia), all legumes, all fishes, cricket, grasshopper mealworm, pork, lamb, all storage mites Moderately positive: buckwheat, lupin, corn, figue, strawberry, celery, pumpkin seeds, poppy seeds and fenugreek Negative or very low: seafood | Buckwheat, lupin, pork, cricket, grasshopper, mealworm, storage mites, fenugreek, poppy seeds | Introducing seafood allowed Avoiding insects from diet Already eating all nuts (except walnut and pecannut) without symptoms |
9 (F; 11) | Cashew nut, pistachio nut, kiwi | Mites, trees, grass, cat | No | Yes | No | Highly positive: cashewnut and pistachio nut, north sea shrimp (Troponin C), storage mite (Gly d 2) Moderately positive: cricket and grasshopper, storage mites (Tyr p; Lep d 2, Aca s) Negative: all other nuts | Cricket, grasshopper, storage mites | No dietary modifications |
10 (M; 8) | Peanut, nuts (except almond), sesame, kiwi | Mites, trees, grass, multiple animals | No | Yes | Yes | Highly positive: all nuts (incl almond), buckwheat, sunflowers seeds, poppy seeds, tuna fish and sword fish (parvalbumines) and chickpeas, storage mites (Lep d2) Moderately positive: lentils, lupin | Chickpeas, lentils, buckwheat, lupin, sunflower and poppy seeds, fish, storage mites | No dietary modifications Eating almonds without symptoms |