Food allergen  Potential clinical cross-reactivity
Peanut  Legumes (soy, lentils, chickpeas)
 High rate of cross-sensitization, but clinical cross-reactivity uncommon (5%)
 Multiple legume allergy may be associated with sensitization to lentil and chickpea
Tree nuts
 Approximately one-third of patients with peanut allergy report clinical reactivity to tree nuts (not evaluated by DBPCFC)
 Significant cross-reactivity between peanut and certain tree nut epitopes (almond, walnut, pecan, hazelnut, Brazil nut)
Seeds
 Co-sensitization is common, but clinical cross-reactivity unknown
Tree nuts  Other tree nuts
 Clinical reactivity to multiple tree nuts reported in up to one-third of patients (37%)
Seeds
 Co-sensitization is common, but clinical cross-reactivity unknown
Peanut (see above)
Walnut  Pecan – clinical cross-reactivity
Coconut – homologous but clinical cross-reactivity rare
Cashew  Pistachio – clinical cross-reactivity