Sign in →

Test Code NUTHR Hazelnut-Food, IgE with Reflex to Hazelnut-Food Components, 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: 1 mL

Collection Instructions: Centrifuge and aliquot serum into a plastic vial.


Useful For

Evaluation of patients with suspected hazelnut-food allergy

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
NUTHX Hazelnut-Food Components, IgE, S No No

Testing Algorithm

Testing begins with analysis of hazelnut-food-specific total IgE. If hazelnut food-specific total IgE is negative (<0.10 kU/L), testing is complete.

 

If hazelnut food-specific total IgE is 0.10 kU/L or more, then the four hazelnut-food components (Cor a 1, Cor a 8, Cor a 9, and Cor a 14) will be performed at an additional charge.

Method Name

Fluorescent Enzyme Immunoassay (FEIA)

Reporting Name

Hazelnut-Food Component Reflex, S

Specimen Type

Serum

Specimen Minimum Volume

0.6 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 hazelnut-food IgE antibody is present (≥0.10 IgE kUa/L), additional specific component IgE antibody testing will be performed. If at least one potential specific allergenic hazelnut-food component IgE is detectable (≥0.10 IgE kUa/L), an interpretive report will be provided.

 

When the sample is negative for total hazelnut-food IgE antibody (<0.10 IgE kUa/L), further testing for specific hazelnut-food component IgE antibodies will not be performed. Negative IgE results for total hazelnut-food antibody may indicate a lack of sensitization to potential hazelnut-food allergenic components.

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 [published correction appears in Br J Nutr. 2008 Feb;99(2):447-8]. 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. Ebo DG, Verweij MM, Sabato V, Hagendorens MM, Bridts CH, De Clerck LS. Hazelnut allergy: a multi-faced condition with demographic and geographic characteristics. Acta Clin Belg. 2012;67(5):317-321

12. Calamelli E, Trozzo A, Di Blasi E, Serra L, Bottau P. Hazelnut Allergy. Medicina (Kaunas). 2021;57(1):67

13. Uotila R, Kukkonen AK, Pelkonen AS, Makela MJ. Cross-sensitization profiles of edible nuts in a birch-endemic area. Allergy. 2016;71(4):514-521

14. Datema MR, van Ree R, Asero R, et al. Component-resolved diagnosis and beyond: Multivariable regression models to predict severity of hazelnut allergy [published correction appears in Allergy. 2020 Aug;75(8):2145-2145]. Allergy. 2018;73(3):549-559

15. Hofmann C, Scheurer S, Rost K, et al. Cor a 1-reactive T cells and IgE are predominantly cross-reactive to Bet v 1 in patients with birch pollen-associated food allergy to hazelnut. J Allergy Clin Immunol. 2013;131(5):1384-92.e6

16. Nilsson C, Berthold M, Mascialino B, Orme M, Sjolander S, Hamilton R. Allergen components in diagnosing childhood hazelnut allergy: Systematic literature review and meta-analysis. Pediatr Allergy Immunol. 2020;31(2):186-196

17. Inoue Y, Sato S, Takahashi K, et al. Component-resolved diagnostics can be useful for identifying hazelnut allergy in Japanese children. Allergol Int. 2020;69(2):239-245

18. Faber MA, De Graag M, Van Der Heijden C, et al. Cor a 14: missing link in the molecular diagnosis of hazelnut allergy?. Int Arch Allergy Immunol. 2014;164(3):200-206

19. Costa J, Mafra I, Carrapatoso I, Oliveira MB. Hazelnut Allergens: Molecular Characterization, Detection, and Clinical Relevance. Crit Rev Food Sci Nutr. 2016;56(15):2579-2605

20. Buyuktiryaki B, Cavkaytar O, Sahiner UM, et al. Cor a 14, Hazelnut-Specific IgE, and SPT as a Reliable Tool in Hazelnut Allergy Diagnosis in Eastern Mediterranean Children. J Allergy Clin Immunol Pract. 2016;4(2):265-72.e3

21. Brough HA, Caubet JC, Mazon A, et al. Defining challenge-proven coexistent nut and sesame seed allergy: A prospective multicenter European study. J Allergy Clin Immunol. 2020;145(4):1231-1239

22. Datema MR, Zuidmeer-Jongejan L, Asero R, et al. Hazelnut allergy across Europe dissected molecularly: A EuroPrevall outpatient clinic survey. J Allergy Clin Immunol. 2015;136(2):382-391

23. Masthoff LJ, van Hoffen E, Mattsson L, et al. Peanut allergy is common among hazelnut-sensitized subjects but is not primarily the result of IgE cross-reactivity. Allergy. 2015;70(3):265-274

24. 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

25. Carraro S, Berardi M, Bozzetto S, Baraldi E, Zanconato S. COR a 14-specific IgE predicts symptomatic hazelnut allergy in children. Pediatr Allergy Immunol. 2016;27(3):322-324

26. Buyuktiryaki B, Cavkaytar O, Sahiner UM, et al. Cor a 14, Hazelnut-Specific IgE, and SPT as a Reliable Tool in Hazelnut Allergy Diagnosis in Eastern Mediterranean Children. J Allergy Clin Immunol Pract. 2016;4(2):265-72.e3

27. Uotila R, Rontynen P, Pelkonen AS, Voutilainen H, Kaarina Kukkonen A, Mäkelä MJ. For hazelnut allergy, component testing of Cor a 9 and Cor a 14 is relevant also in birch-endemic areas. Allergy. 2020;75(11):2977-2980

Day(s) Performed

Monday through Friday

Report Available

Same day/1 to 3 days

Performing 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
NUTHR Hazelnut-Food Component Reflex, S 6136-6

 

Result ID Test Result Name Result LOINC Value
NUTH1 Hazelnut-Food, IgE, S 6136-6

Forms

If not ordering electronically, complete, print, and send an Allergen Test Request (T236) with the specimen.