The British Society for Allergy and Clinical Immunology (BSACI) has published a new guideline for the management of nut allergy, which aims to help define diagnostic pathways, including the role of specific IgE testing.

Current diagnostic approaches including skin prick tests and whole nut-specific serum IgE tests. The guideline also recommends a new type of test, which is based on reactions to specific proteins within nuts. This new test currently applies only to peanut allergies, but work is being done to identify two hazelnut proteins.

The new guideline seeks to add context to decision making and give practical help to healthcare professionals, enabling them to identify and prioritise those patients most in need of diagnosis and support. New and updated areas covered by the guideline also include:

  • identifying high-risk groups of patients (e.g. young children with severe eczema or an egg allergy) and assessing siblings
  • the latest thinking on allergy management, particularly for children
  • comprehensive management plans including avoidance advice and emergency treatment
  • making effective use of a range of specialists, including dietitians
  • a summary of latest thinking on key areas including—
    • new approaches to weaning that involve introducing peanut protein as part of the process
    • clinical trials of peanut oral immunotherapy.