← All allergens

Brazil nut allergy

Brazil nut allergy is an IgE-mediated immune reaction to the proteins in brazil nut, Bertholletia excelsa, and it is one of the tree-nut allergies most consistently linked to severe, whole-body reactions, even though brazil nut is eaten far less than most nuts. In plain terms: your child’s immune system reads certain brazil-nut proteins as a threat, and a reaction can run from hives to a whole-body allergic reaction that affects breathing and blood pressure, called anaphylaxis. Brazil nut has a second feature worth knowing up front: it is a taxonomically isolated nut, so a brazil-nut allergy is often a narrower, more isolated allergy than the other tree nuts, and frequently it is the only nut a child reacts to. Tree-nut allergy as a group affects roughly 1 percent of the population in Western surveys (McWilliam 2015); a clean brazil-nut-specific number is not separately established, so this page does not invent one.

If your child was just diagnosed, read this first.

This page is long on purpose. It is also the page you will come back to for years. You do not need all of it today. This week, this is what matters:

  • Carry epinephrine everywhere your child goes if your allergist has prescribed it, and learn the few signs that mean use it now. That is the section to read tonight (Emergency preparedness, below). If you do not have the prescription yet, that is the first call to your allergist or pediatrician.
  • Read every label, every time. The words to catch are brazil nut, brazil nuts, para nut, Bertholletia excelsa, and the catch-all mixed nuts and tree nut (Reading labels, below).
  • Brazil nut is one of the more dangerous tree nuts drop for drop, so take a brazil-nut reaction seriously even if it looked small.
  • The other tree nuts are a separate question, not an automatic yes and not an automatic no. Brazil nut is taxonomically off on its own, so a brazil-nut allergy is often isolated, but the other nuts are still tested, not assumed (Cross-reactivity, below).
  • You do not have to understand the protein science to keep your child safe. The components and the test names (Components, below) are for unhurried conversations with your allergist.
  • Ask your allergist about the one high-value test by name: Ber e 1 (Components, below).

Everything else here is waiting for you, in roughly the order the questions tend to come up. Read it when you want it.

Where a fact below is clinical, it carries its source. None of it is a substitute for your allergist.

What brazil nut allergy is, and who has it

Brazil nut allergy is an IgE-mediated immediate-type food allergy, and in that form it is anaphylaxis-capable, which is the reason for the auto-injector, the label habit, and the written plan (Sicherer 2018). When your child eats brazil nut, IgE antibodies on their immune cells latch onto the brazil-nut proteins and trigger a release of histamine and other chemicals within minutes. That release is the reaction.

Brazil nut is a true tree nut for labeling but botanically the seed of a tree in the Lecythidaceae family, which is not shared by any other major tree nut (Sicherer 2018). That isolation matters, and it comes up under Cross-reactivity, below: brazil nut does not have a close edible cousin the way cashew has pistachio, so a brazil-nut allergy is frequently isolated, and many brazil-nut-allergic children react to no other nut. What does not change with isolation is severity. Brazil nut is among the tree nuts most consistently associated with systemic and anaphylactic reactions, and a disproportionately frequent cause of severe tree-nut reactions relative to how little of it people eat, so it is treated as epinephrine-first. That is a population-level statement about the nut, not a prediction about your individual child, whose risk is set by component profile, history, and cofactors.

A clean, challenge-confirmed brazil-nut-specific prevalence figure is not separately established. Tree-nut allergy as a group runs about 1 percent of the population in Western surveys (McWilliam 2015, a systematic review), and brazil nut is reported within that tree-nut group rather than as its own percentage, so a precise brazil-nut figure is not asserted here because none is grounded. Onset is usually in childhood, consistent with the other storage-protein tree nuts.

Diagnosis combines your child’s history with testing, and for brazil nut the testing has one high-value move worth knowing about. The next section is what it is.

The components that drive severity

Brazil nut is not one thing to the immune system. It is a small set of proteins, and which one your child reacts to changes how serious the allergy tends to be. For brazil nut there is one marker that carries almost all of the weight, and asking for it by name is the highest-value thing you can do.

A standard brazil-nut test (the skin prick, or the basic blood test to whole brazil nut) only tells you the immune system has noticed brazil nut at all, and like the other tree nuts that signal over-calls: a positive skin or blood test in a sensitized-but-tolerant child is common, so a positive test alone over-diagnoses brazil-nut allergy and is read against history (Santos 2023). A more detailed test, component testing, breaks the result down protein by protein. For brazil nut the protein that matters most is the one your allergist calls Ber e 1. It is the heat-stable, digestion-resistant storage protein that drives the serious, whole-body kind of brazil-nut allergy, and it is one of the better-characterized single-component severity markers among all the tree nuts (Bublin 2014). Unlike almond, brazil nut does not have a well-established milder, pollen-linked counterpart protein to reassure you with; the brazil-nut picture is mostly about how strong the Ber e 1 signal is.

So the high-value move is simple: ask your allergist to measure Ber e 1-specific IgE, not just whole-brazil-nut IgE, and ask what the result means for severity and for the avoidance plan. You do not need to learn the protein names yourself. They are below, written so the words on your child’s lab report mean something when you want them to.

The deeper version: the brazil-nut proteins and the test numbers (for your allergist conversation)

Component-resolved testing is run by ImmunoCAP (singleplex), the ImmunoCAP ISAC multiplex, or the ALEX2 / Allergy Explorer 2 multiplex (the last with a CCD inhibitor that cuts carbohydrate-driven false positives in children sensitized to many things at once). The brazil-nut components:

Ber e 1 is the 2S albumin and the protein that matters most. It is a small, compact, methionine-rich storage protein, heat-stable and digestion-resistant, which is why roasting does not defuse brazil nut and why a Ber e 1-driven reaction can be whole-body (Bublin 2014). A positive storage-protein result like this is a red flag for systemic reactions, not a reassuring low-risk finding. The brazil-nut literature does not establish a single universal Ber e 1 sIgE decision number the way it has for peanut’s Ara h 2, so there is no magic cutoff to decode; your allergist reads the level against your child’s history and, where the picture is unclear, a supervised challenge.

Ber e 2 is the 11S legumin and a genuinely minor contributor to brazil-nut allergy. Brazil nut is the tree-nut case where the dominant storage protein is the 2S albumin (Ber e 1) rather than the 11S legumin, so Ber e 2 is the smaller player here (Bublin 2014). That it is a minor contributor is not the same as a reassuring result: the severity question is answered by Ber e 1, and a Ber e 2 finding does not relax the avoidance plan on its own.

There is no birch-pollen / oral-allergy mild axis established for brazil nut the way there is for almond or hazelnut, so brazil nut does not split into a “serious kind versus mild kind”; it is the serious kind, graded by the Ber e 1 signal. One note for later: brazil nut has no approved oral immunotherapy and no brazil-nut-specific active-treatment change to these numbers, so unlike the peanut or egg pages there is no active-treatment modulation section here.

Cross-reactivity, real and reassuring

Brazil nut is one of the rare cases where this section is genuinely short, and the reason is reassuring on one axis and serious on another. Brazil nut is taxonomically isolated, the only common edible nut in its plant family, so it does not have a close cousin that travels with it the way cashew has pistachio, and a brazil-nut allergy is frequently an isolated one, often the only nut a child reacts to. There is no cleared, established “if your child reacts to brazil nut they will also react to nut X” rule on our verified floor. What brazil-nut cross-reactivity comes down to is one serious mechanism, not a web of foods, and naming it is more useful than a list.

The storage-protein mechanism is the serious one, and it is not reassuring. The brazil-nut protein that drives whole-body reactions, Ber e 1, is a potent 2S albumin, the same heat-stable, digestion-stable class of storage proteins that drive severe reactions across the tree nuts. A positive test to a tree-nut storage protein is a red flag for whole-body reactions, not a minor or reassuring result, and cooking or roasting does not change that. For brazil nut specifically, Ber e 1 is that protein. This does not mean a brazil-nut-allergic child is automatically allergic to other nuts. It means a brazil-nut reaction through Ber e 1 is the systemic kind, and a positive test to another nut’s storage protein deserves to be taken seriously rather than waved off, with the allergist testing and deciding nut by nut.

The other tree nuts are a separate question: tested, not assumed. Whether a brazil-nut-allergic child can eat almond, cashew, hazelnut, walnut, pecan, pistachio, or macadamia is a real and common question, and the honest answer is that it is decided one nut at a time by your allergist, not pulled along automatically by the brazil-nut result. Because brazil nut sits alone in its plant family and is frequently a monosensitization, the panel often turns out narrower than parents fear, which is genuinely encouraging, but that is a reason to test the other nuts rather than to assume them safe. There is no cleared blanket rule in either direction, and this page will not tell you your child can eat the other nuts or that they cannot. Your allergist tests and decides.

The one clear reassurance: coconut. Coconut, despite the name and the FDA’s historical labeling rule, is botanically a fruit (a drupe), not a true tree nut, and most tree-nut-allergic people tolerate it. Coconut is usually a yes, confirmed with your allergist before you introduce it rather than assumed.

Hidden sources

Brazil nut is a lower-burden tree nut to scan for than almond or cashew, because it does not turn up as a flour, a milk, or a paste, but it does hide in the places nuts are mixed together. These are worth a one-time read now; after that you will spot them on your own. For the full label-scanning guide, see where brazil nut hides.

Mixed-nut products. The most common way brazil nut hides is in mixed-nut and nut-mix products, where a label may say nut mix or a generic tree nut without naming brazil nut individually. Trail mixes, snacking-nut assortments, and the nut bowl at a gathering are the everyday cases.

Chocolate confections and snack bars. Brazil nut appears in some chocolate confections and in nut-based snack and energy bars, sometimes without prominence beyond the ingredient line. Check the ingredient list on any nut-containing chocolate or bar rather than relying on the front of the package.

A curiosity worth clearing. In the 1990s a genetically engineered soybean line was made with a brazil-nut protein (Ber e 1) to improve its nutrition, and it was found to carry brazil-nut allergenicity and was never brought to market. It is named here only so the story, which still circulates, is not mistaken for a present-day risk: there is no brazil-nut protein hiding in the soybeans on the shelf, and this is not a brazil-nut-and-soy cross-reactivity. It is a piece of food-safety history, not a current exposure.

How exposure actually happens

The routes parents fear most are usually not the ones that cause serious reactions. Eating brazil nut is. The rest are lower-risk than they feel.

Eating it (high). Swallowing brazil-nut protein is the route that causes whole-body reactions. Everything else is far behind it. Cooking does not help: Ber e 1 is heat-stable, so roasted or cooked brazil nut stays allergenic for a child who reacts to it. Brazil nut is most often met whole or chopped in mixed-nut products and confections rather than as a refined ingredient.

Skin contact (low). Brazil nut on intact skin usually causes at most a local reaction. As with other food allergens the risk is higher on broken or eczematous skin, but brazil nut is not a high skin-contact-risk allergen.

Breathing it in (low). Brazil nut is not volatile, so ambient smell is low-risk for the typical child.

There is no separate medical-care category to flag for brazil nut. Unlike egg, brazil nut is not an ingredient in routine vaccines or anaesthetic agents at the quality floor this page renders from, so there is no vaccine or anaesthesia step specific to brazil nut. As always, tell every provider about your child’s allergies; there is simply no brazil-nut-specific medical-care warning to render.

Reading labels

This is the habit that does the most day-to-day work, and it gets fast. The words to scan for are brazil nut, brazil nuts, para nut, and Bertholletia excelsa. In the US, brazil nut is one of the tree nuts that must be named specifically under FALCPA, and the EU and UK require tree-nut declaration under Regulation 1169/2011 (FALCPA; EU 1169).

A few terms are signals to slow down: mixed nuts and nut mix (which may contain brazil nut without enumerating it), and a generic tree nut declaration (which can stand in for brazil nut without naming it). When a term is unclear and the manufacturer will not say, treat it as a reason to call the company, not a reason to assume it is safe.

Then there are the precautionary labels: “may contain tree nuts,” “made in a facility that processes tree nuts.” These are voluntary and unregulated in both the US and the EU, so they are not a reliable measure of how much risk is actually present. How strictly you treat them is a personal call along a spectrum, weighing a real but variable cross-contact risk against ruling out a large share of the grocery store. This page will not pick that threshold for you.

Severity, and what predicts a bad reaction

The strongest population-level predictor of a severe brazil-nut reaction is sensitization to Ber e 1 (the 2S albumin described above), and its magnitude; a history of a previous severe reaction is the next strongest input. Brazil nut is among the tree nuts most consistently associated with systemic and anaphylactic reactions, which is exactly why a brazil-nut reaction is taken seriously even when the amount eaten was small. Brazil nut has no established cofactor syndrome of the lipid-transfer-protein kind, so the picture is mostly about the Ber e 1 signal and the history.

Here is the part that justifies carrying epinephrine when your allergist has prescribed it. The size of the last reaction does not reliably predict the next one, and brazil nut can cause anaphylaxis, including at a small exposure. A child whose only reaction so far was mild can still have a worse one next time. That is not a reason to live in fear; it is the reason the auto-injector travels with the child while the allergist sorts out the picture.

Emergency preparedness

Brazil-nut anaphylaxis is treated epinephrine-first. Epinephrine is the first-line treatment for a severe reaction, not an antihistamine and not a wait-and-see. If you see anaphylaxis, you give epinephrine and then you call emergency services.

The signs that mean epinephrine now include any two body systems reacting at once (for example hives plus vomiting), or any single severe sign on its own: trouble breathing, throat tightness, a hoarse or weak cry, repetitive coughing, pale or floppy appearance, or a sense of impending doom in a child old enough to say so. When you are unsure, the guidance is to give epinephrine, because the danger of withholding it in a true reaction is far greater than the danger of giving it when it turns out you did not need to.

After giving epinephrine, call emergency services and lay the child down with legs raised, unless breathing is the main problem, in which case let them sit up. A second dose may be needed if there is no improvement in about five minutes, and on any progression to faintness, worsening breathing, or a reaction that comes back after seeming to settle, treat it as an escalation and follow the written plan. Every brazil-nut-allergic child whose allergist has prescribed it should have a written anaphylaxis action plan and the epinephrine auto-injectors that go everywhere the child goes.

This section is general. Your child’s own plan is the specific one, and it is the one to follow.

When you can’t tell what’s happening

The hardest moments are usually not the clear reactions. They are the ambiguous ones. A flushed cheek after a new food. A single cough. A child who says their mouth feels itchy after a snack you did not pack. Telling the start of a reaction apart from an ordinary toddler complaint is genuinely hard, and it does not resolve cleanly from across the room.

The posture that works is to treat the spectrum, not to diagnose it in the moment. Know your action plan’s override signs cold, watch whether more than one body system is involved rather than fixating on a single symptom, and accept that you will sometimes give epinephrine or call the allergist for something that turns out to be nothing. That is the system working the way it is supposed to. An itchy mouth that stays an itchy mouth is one thing; an itchy mouth that is joined by hives, vomiting, a cough, or any trouble breathing is the picture to act on, and with a nut as potent as brazil nut a fast pivot to the plan is the right instinct.

The competence here builds slowly, over many ambiguous afternoons. It shows up as a shorter pause before you act.

Treatment options

Strict avoidance is the floor, and for brazil nut it is most of the answer. Avoidance plus a written action plan plus the epinephrine your allergist prescribes is the standing setup for a brazil-nut-allergic child, and because Ber e 1 is heat-stable, that avoidance includes cooked and roasted brazil nut, not just raw (Togias 2017).

Brazil nut is different from peanut and egg in one important way: there is no FDA-approved brazil-nut treatment, and no brazil-nut-specific oral immunotherapy. What exists beyond avoidance is an adjunct and a pipeline.

Omalizumab (Xolair). This is an anti-IgE antibody, given by injection, FDA-approved on 2024-02-16 to reduce IgE-mediated reactions to one or more foods, including tree nuts, for ages 1 and up. Brazil nut is not named on its own in the approval, which was based on a multi-food program, but a child managed for multiple food allergies that include brazil nut can fall within the one-or-more-foods indication (Xolair FDA 2024). It lowers the severity of an accidental exposure; it is not a cure and not a brazil-nut desensitization, and it does not remove the need for avoidance and a plan. Whether it fits your child is an allergist conversation.

The broader pipeline. There is no established brazil-nut oral immunotherapy, and brazil nut is not a named single-nut OIT target. Multi-nut oral immunotherapy and other biologics are in trial and research settings, the landscape is in flux, and where research protocols exist their eligibility and dosing vary by center. It is tracked, not prescribed; whether any of it applies to one child is a conversation with their allergist along that spectrum, and this page does not name a single option or enrollment threshold.

Not medical advice. Whether to treat at all, and how, is a conversation with your allergist.

Day-to-day living

School and day care. A brazil-nut-allergic child needs a written plan on file, epinephrine truly accessible if prescribed, trained staff, and a clear routine for snacks, classroom parties, baking projects, and substitute teachers. In US public schools, a 504 plan is the usual way to put that in writing. The nut bowl, the trail-mix snack, and the bake-sale brownie are the everyday brazil-nut settings to watch.

Restaurants. The risk is mixed-in brazil nut more than an obvious menu item: nut assortments, nut-topped desserts and salads, and chocolate or nut-based confections. A chef card that names brazil nut plainly, and asks about mixed nuts, does more than a verbal order across a loud kitchen.

Travel. Bring more epinephrine than you think you need (if prescribed), carry food you trust, and look up pharmacies and emergency numbers before you land. Brazil nut shows up in South American and European confectionery and in nut assortments, so confirm local dishes and snacks carefully.

Holidays and gatherings. The mixed-nut bowl, nut-studded baking, chocolates, and trail mix are the brazil-nut-dense settings. Bringing your child’s own food and being plain with hosts beats hoping a buffet is safe.

Prognosis and outgrowing

Brazil nut, like the tree-nut allergies driven by the heat-stable and digestion-stable storage proteins, is generally regarded as commonly persistent and frequently lifelong, in contrast to milk and egg (Fleischer 2005). The supportable favorable sign is a declining brazil-nut or Ber e 1-specific IgE over serial testing, stated as a direction rather than a number, since no brazil-nut-specific resolution threshold is established.

Reassessment timing is individualized and varies by allergist practice, the child’s reaction history, and the specific-IgE trajectory, and no brazil-nut-specific interval is established in the literature; the schedule for any one child is a conversation with their allergist. The one definitive test of whether your child can eat brazil nut is a supervised oral food challenge, offered when the specific IgE has fallen into a favorable range and the child has been reaction-free; because brazil nut carries a high systemic-reaction profile, that challenge is performed under supervision with resuscitation capability (Santos 2023). Falling numbers are encouraging but supportive, not proof.

Questions for your allergist

You do not have to walk in knowing the science. You have to walk in with the right questions, and these are them.

  1. Should we ask for component testing to Ber e 1, and what does my child’s Ber e 1-specific IgE value and its trend mean for how serious this is and for the avoidance plan?
  2. Is my child’s brazil-nut allergy likely to be isolated, or do we need to test the other tree nuts, and where does coconut fit?
  3. Which other tree nuts (almond, cashew, hazelnut, walnut, pecan, pistachio, macadamia) should we treat as off-limits, and which can we test one at a time?
  4. Which hidden brazil-nut sources (mixed nuts, chocolate confections, snack bars) matter most for how we actually eat?
  5. When and how should we reassess to see whether my child has outgrown it, given that brazil nut is usually persistent?
  6. What will epinephrine, and any treatment we are considering, actually cost us, and what does our insurance cover?

The frame: how to hold this

There are two worlds, and a food allergy moves a family from one into the other. In the recoverable world, a mistake is a lesson. A forgotten jacket is a cold afternoon. In the irrecoverable world, one wrong protein is not a lesson, because the cost of the error can be the child. When someone tells an allergy parent to relax, they are speaking from the first world to someone who has had to move to the second. They think the parent is anxious. The parent is not anxious. The parent is calibrated.

The work, then, is to sort what is on your side of the line from what is not. On your side: the labels you read, the Ber e 1 test you ask for, the question you ask about whether the other nuts are even in play, the epinephrine that travels with the child, the chef card, the plan on file at school. Not on your side: the trail mix that blends brazil nut in without flagging it, the relative who thinks one nut is kindness, the manufacturer whose precautionary label is voluntary. You do the things on your side fully, and you stop apologizing for them. And you hold, without pretending otherwise, that the other side is real and partly random, and that a stacked defense reduces the risk without ever closing the gap to zero.

Brazil nut carries a particular shape of this. It is often an isolated allergy, which is a real and narrow piece of good news, because it can mean the rest of the world stays open in a way it does not for a child allergic to a whole cluster of nuts. And it is one of the more dangerous nuts drop for drop, which means the narrowness is not the same as mildness. Both are true, and a brazil-nut family holds them together: a smaller perimeter to defend, defended seriously. This page does not promise safety. It lays out the layers and names the gap, and it leaves the calibration to you and your allergist.

  • Where brazil nut hides: the full label-reading guide and the mixed-nut catch
  • Brazil nut cross-reactivity, why an isolated nut allergy is common
  • The storage proteins: why a positive 2S-albumin test is a red flag, not reassuring
  • Reading labels for brazil nut and mixed nuts, the deep version
  • Brazil nut and the other tree nuts, what “tested, not assumed” means
  • Building a brazil-nut-allergy 504 plan
  • Restaurants with a brazil-nut-allergic child

The companion pages without a link are being written and will be linked here as each one goes live.

Frequently asked questions

Is brazil nut a tree nut?

For allergy and labeling purposes, yes. Brazil nut is a named major tree-nut allergen, the seed of a tree in the Lecythidaceae family. That is why it must be declared on labels and why it is grouped with the tree nuts, even though botanically it is not closely related to the other common tree nuts.

If my child is allergic to brazil nut, are they allergic to the other tree nuts too?

Not necessarily, and often not. Brazil nut sits alone in its plant family and is frequently an isolated allergy, so many brazil-nut-allergic children react to no other nut. But there is no blanket rule in either direction, so the other tree nuts are tested by your allergist, not assumed safe or unsafe (see Cross-reactivity).

Does roasting or cooking make brazil nut safe?

No. Brazil nut’s main allergenic protein, Ber e 1, is heat-stable and survives digestion, so roasting, baking, and cooking do not make brazil nut safe for a brazil-nut-allergic child.

Is coconut a problem for a brazil-nut allergy?

Usually not. Coconut is botanically a fruit, not a true tree nut, and most tree-nut-allergic people tolerate it, though confirm with your allergist before introducing it.

Is there a treatment for brazil nut allergy?

There is no FDA-approved brazil-nut-specific treatment and no approved brazil-nut oral immunotherapy. Omalizumab (Xolair) is FDA-approved to reduce reactions across one or more foods including tree nuts, which can cover brazil nut for a child managed for several food allergies. It is an allergist conversation, not a self-directed step (see Treatment options).

Voices: living with brazil nut allergy

Attributed lived experience, kept separate from the clinical facts above. These are individual accounts, not medical guidance, and they carry no clinical claim the page above has not already made. Brazil-nut-specific first-person stories are genuinely rare, so this is a short, single-voice block.

A woman recalls growing up allergic to all nuts in the years before ingredient labels and anaphylaxis awareness, naming her own allergens as “not just walnuts in fact, but all nuts: Brazil nuts, almonds, pistachios, pecans, pralines, and peanuts.” She describes her first anaphylactic reaction as a child in 1971, when her mother gave her a piece of walnut and her throat began to close, and credits her mother with keeping her safe through the “food allergy dark ages.”

Source: Tamar Evangelestia-Dougherty, Allergic Living, 2017. https://www.allergicliving.com/2017/05/12/stayin-alive-in-the-70s-before-allergy-labels-there-was-mom/ One person’s experience of growing up allergic to several tree nuts including brazil nut, not a description of all brazil-nut allergy and not medical guidance. Her triggering reaction was to a walnut, not a brazil nut.

References and medical review

This page is pending independent medical review; the note at the top of the page applies until a reviewer is assigned. The references below resolve every in-body citation. The storage-protein-not-reassuring rule and the coconut reassurance resolve to the project’s verified cross-reactivity floor; brazil nut has no pairwise cross-food edge and no separate hidden-source floor record, so the taxonomic-isolation shape and the hidden-source list are drawn from the project’s brazil-nut research.

  1. Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol. 2018;141(1):41-58. https://doi.org/10.1016/j.jaci.2017.11.003
  2. McWilliam V, Koplin J, Lodge C, Tang M, Dharmage S, Allen K. The Prevalence of Tree Nut Allergy: A Systematic Review. Curr Allergy Asthma Rep. 2015;15(9):54. https://doi.org/10.1007/s11882-015-0555-8
  3. Bublin M, Breiteneder H. Cross-reactivity of tree nut and 2S-albumin storage-protein allergens (Ber e 1 / Ber e 2 component context). Curr Allergy Asthma Rep. 2014;14(4):426. https://doi.org/10.1007/s11882-014-0426-8
  4. Santos AF, Riggioni C, Agache I, et al. EAACI guidelines on the diagnosis of IgE-mediated food allergy. Allergy. 2023;78(12):3057-3076. https://doi.org/10.1111/all.15902
  5. Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2017;139(1):29-44. Applied here for the baseline-of-care avoidance and anaphylaxis-management defaults. https://doi.org/10.1016/j.jaci.2016.10.010
  6. Fleischer DM, Conover-Walker MK, Matsui EC, Wood RA. The natural history of tree nut allergy. J Allergy Clin Immunol. 2005;116(5):1087-1093. Reports tree-nut allergy as a group; no brazil-nut-specific quantified resolution rate. https://doi.org/10.1016/j.jaci.2005.09.002
  7. US FDA. FDA approves first medication to help reduce allergic reactions to multiple foods after accidental exposure (omalizumab, Xolair; one or more foods, ages 1 and up; approved 2024-02-16). https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-help-reduce-allergic-reactions-multiple-foods-after-accidental
  8. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), Title II of PL 108-282; tree nuts named individually (brazil nut on the FDA tree-nut list). https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-information/food-allergen-labeling-and-consumer-protection-act-2004-falcpa
  9. Regulation (EU) No 1169/2011 (Annex II allergens, tree nuts including brazil nut, Bertholletia excelsa); UK on the retained-EU-law basis. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32011R1169

← All allergens