Anafi laxia secundaria a ingesta de avellana: reporte de un caso

Introduction: Hazelnut allergy can range from mild oral symptoms to potentially dangerous anaphylaxis. It is estimated that allergy to nuts, including hazelnut has a prevalence of 1%. Description of the case: 17 years male, with no history of atopy. History of chronic conjunctivitis, keratoconus in the left eye with corneal transplantation, allergic rhinitis and bronchial asthma managed with immunotherapy. Actual disease: Twenty minutes after intake of chocolate (with hazelnut) patient presented bilateral eyelid edema, earache, angioedema, sensation of drowning; Physical examination: eyes closed, diffi culty opening bilateral conjunctival erythema, cobblestone papillae, oral cavity edematous uvula, tendency to bradycardia. Adrenaline is handled with good response. ImmunoCAP is requested with sensitization to hazelnut, peanut, almond and walnut. Discussion: Anaphylaxis due to hazelnut in our country is poorly documented. Of the proteins involved, some are related with oral allergy syndrome and the others with cross-reactivity to dried fruit (or both), the latter with increased risk of anaphylaxis. It’s important to diagnose by molecular biology and important to have self-injectable adrenaline for prehospital management. Conclusions: We should not consider food allergies nonexistent with hazelnut anaphylaxis. The correct diagnosis and treatment reduces the risk of subsequent events.