2025 Volume 74 Issue 3 Pages 133-138
Purpose: The research on macadamia nut oral food challenge (OFC) is limited. This study aimed to evaluate the clinical characteristics of macadamia nut OFC by evaluating data from our department.
Methods: This study retrospectively analyzed macadamia nut OFC data from medical record from January 2013 to June 2024, targeting loading doses of 1 gram and 10 grams. The relationships between OFC outcomes, patient demographics, and macadamia nut skin prick test (SPT) results were assessed.
Results: A total of 66 patients were included, with 33 patients in the 1 gram and 10 gram loading dose groups each. The OFC positivity was observed in 27% of patients at 1 gram and 12% at 10 grams. Among the positive cases, the anaphylaxis induction rates were 52% for the 1 gram group and 3% for the 10 gram group. Univariate analysis revealed that the macadamia nut SPT was not predictive of anaphylaxis. However, a history of immediate allergic reactions to macadamia nuts and the diameter of macadamia nut SPT swelling were associated with OFC positivity.
Conclusion: Macadamia nut OFC has the potential to induce severe allergic reactions, including anaphylaxis. Adequate preparation and precautionary measures should be put in place when conducting macadamia nut OFC to manage potential risks effectively.
