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HelpTest Code CASHR Cashew, IgE with Reflex to Cashew Component, IgE, Serum
Ordering Guidance
For a listing of allergens available for testing, see Allergens - Immunoglobulin E (IgE) Antibodies
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Useful For
Evaluation of patients with suspected cashew allergy
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CASHX | Cashew Component, IgE, S | No | No |
Testing Algorithm
Testing begins with analysis of cashew-specific total IgE. If the cashew-specific total IgE result is negative (<0.10 kU/L), testing is complete.
If the cashew-specific total IgE result is 0.10 kU/L or more, then the cashew component (Ana o 3) test will be performed at an additional charge.
Special Instructions
Method Name
Fluorescent Enzyme Immunoassay (FEIA)
Reporting Name
Cashew Component Reflex, SSpecimen Type
SerumSpecimen Minimum Volume
0.4 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 90 days |
Reference Values
|
Class |
IgE kU/L |
Interpretation |
|
0 |
<0.10 |
Negative |
|
0/1 |
0.10-0.34 |
Borderline/Equivocal |
|
1 |
0.35-0.69 |
Equivocal |
|
2 |
0.70-3.49 |
Positive |
|
3 |
3.50-17.4 |
Positive |
|
4 |
17.5-49.9 |
Strongly positive |
|
5 |
50.0-99.9 |
Strongly positive |
|
6 |
≥100 |
Strongly positive |
Concentrations of 0.70 kU/L or more (class 2 and above) will flag as abnormally high.
Reference values apply to all ages.
Interpretation
When detectable total cashew IgE antibody is present (≥0.10 IgE kUa/L), additional specific component IgE antibody testing will be performed. If a potential specific allergenic cashew component IgE is detectable (≥0.10 IgE kUa/L), an interpretive report will be provided.
When the sample is negative for total cashew IgE antibody (<0.10 IgE kUa/L), further testing for specific cashew component IgE antibodies will not be performed. A negative IgE result for total cashew antibody may indicate a lack of sensitization to the potential cashew allergenic component.
Clinical Reference
1. Salo PM, Arbes SJ Jr, Jaramillo R, et al. Prevalence of allergic sensitization in the United States: results from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. J Allergy Clin Immunol. 2014;134(2):350-359
2. Waserman S, Watson W. Food allergy. Allergy Asthma Clin Immunol. 2011;7 Suppl 1(Suppl 1):S7
3. Abrams EM, Sicherer SH. Diagnosis and management of food allergy. CMAJ. 2016;188(15):1087-1093
4. Weinberger T, Sicherer S. Current perspectives on tree nut allergy: a review. J Asthma Allergy. 2018;11:41-51
5. Lomas JM, Jarvinen KM. Managing nut-induced anaphylaxis: challenges and solutions. J Asthma Allergy. 2015;8:115-123
6. Maloney JM, Rudengren M, Ahlstedt S, Bock SA, Sampson HA. The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy. J Allergy Clin Immunol. 2008;122(1):145-151
7. Sicherer SH, Burks AW, Sampson HA. Clinical features of acute allergic reactions to peanut and tree nuts in children. Pediatrics. 1998;102(1):e6
8. Crespo JF, James JM, Fernandez-Rodriguez C, Rodriguez J. Food allergy: nuts and tree nuts. Br J Nutr. 2006;96 Suppl 2:S95-S102
9. Yang L, Clements S, Joks R. A retrospective study of peanut and tree nut allergy: Sensitization and correlations with clinical manifestations [published online ahead of print, 2015 Feb 27]. Allergy Rhinol (Providence). 2015;doi:10.2500/ar.20105.6.0108
10. Masthoff LJ, Hoff R, Verhoeckx KC, et al. A systematic review of the effect of thermal processing on the allergenicity of tree nuts. Allergy. 2013;68(8):983-993
11. Davoren M, Peake J. Cashew nut allergy is associated with a high risk of anaphylaxis. Arch Dis Child. 2005;90(10):1084-1085
12. Robotham JM, Wang F, Seamon V, et al. Ana o 3, an important cashew nut (Anacardium occidentale L.) allergen of the 2S albumin family. J Allergy Clin Immunol. 2005;115(6):1284-1290
13. Clark AT, Anagnostou K, Ewan PW. Cashew nut causes more severe reactions than peanut: case-matched comparison in 141 children. Allergy. 2007;62(8):913-916
14. Mendes C, Costa J, Vicente AA, Oliveira MBPP, Mafra I. Cashew nut allergy: Clinical relevance and allergen characterisation. Clin Rev Allergy Immunol. 2019;57(1):1-22
15. Blazowski L, Majak P, Kurzawa R, Kuna P, Jerzynska J. Food allergy endotype with high risk of severe anaphylaxis in children-Monosensitization to cashew 2S albumin Ana o 3. Allergy. 2019;74(10):1945-1955
16. Bastiaan-Net S, Batstra MR, Aazamy N, et al. IgE cross-reactivity measurement of cashew nut, hazelnut and peanut using a novel IMMULITE inhibition method. Clin Chem Lab Med. 2020;58(11):1875-1883
Day(s) Performed
Monday through Friday
Report Available
Same day/1 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
86003
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CASHR | Cashew Component Reflex, S | 6718-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CASH1 | Cashew, IgE, S | 6718-1 |
Forms
If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.