Table 1:

Literature Review of Almond Challenge Outcomes

Study Design	Almond Diagnostics	Almond Challenge Outcomes
Andorf et al JACI in Practice 2017(10) • n=165 patients with possible allergy to 2+foods receiving 311 challenges	• median SPT 9.5 mm (range 6–25 mm) • median IgE 5.2 kU/L (range 0.4–100 kU/L)	• n=21 challenges to almond • 10 reactions = 52% passage rate • 48% with skin reaction, 0% with GI reaction, 10% with respiratory symptoms, 0% with epi
Couch et al Ann Allergy Asthma Immunol 2017(9) • n=109 patients with tree nut allergy receiving 156 challenges	• mean sIgE 1.18 (median 0) • mean SPT 1.27 (median 0) • 42 with sIgE <2 • 6 with sIgE >=2 • 37 with SPT <3 • 11 with SPT >3	• 57 challenges • 100% passage rate
Elizur et al Allergy 2018(8) • n=83 patients with peanut / tree nut allergy receiving 232 challenges	• 49 with SPT >3 mm • exact SPT & IgE not specified	• 49 challenges • 1 clinical reaction = 98% passage rate
Rodriguez et al JACI 2000(9) • n=34 with suspected Rosaceae food allergy • performed SPT, IgE and if positive, then OFC to all Rosaceae foods (apricot, almond, plum, strawberry, apple, peach, pear)	• 4 with reported almond clinical history • 18 with positive almond-specific SPT or IgE • exact SPT & IgE not specified	• 18 challenges to individuals with sensitization • 1 clinical reaction = 94% passage rate • Only oral symptoms • Rate of clinical reactivity for those with positive SPT (n=15): 7% • Rate of clinical reactivity for those with positive IgE (n=6): 17%