ArticlePediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology2026
Hazelnut oral immunotherapy in children: An Italian single-center retrospective cohort study.
Article in Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Hazelnut oral immunotherapy in children: An Italian single-center retrospective cohort study.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
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10 authors.
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Abstract
introductionHazelnut oral immunotherapy (H-OIT) is a promising treatment for hazelnut allergy (HA). The aim of this study was to assess the safety and efficacy of H-OIT in a pediatric population, while describing its clinical and allergy characteristics.
methodsChildren undergoing H-OIT at our tertiary pediatric hospital Allergy Unit between April 2015 and December 2024 were enrolled. Demographic and clinical features, allergy test results and information on H-OIT were recorded.
results124 patients (58.1% male; median age 8.5 years) were enrolled, 73 (58.9%) aged <4 years. The most common presenting symptom was urticaria/angioedema (75, 60.5%), followed by anaphylaxis (54, 43.5%). 54/124 (43.5%) reached the protocol's target maintenance dose within a median time of 24 months, 31/124 (25.0%) remained on a lower, partial maintenance dose at a median tolerated dose of 1000 mg of ground hazelnut. The treatment discontinuation rate was 31.5%, with over half (53.9%) due to loss to follow-up. 102/124 (82.3%) developed a reaction during H-OIT (72.5% resolved spontaneously, 14.7% occurred at home), of which 9 anaphylaxis (8.8%); only one required adrenaline, and two occurred at home because of a cofactor. Statistically significant reductions in the prick-by-prick (PbP) test diameter (p < 0.001) and Cor a 14 IgE levels (p = 0.004) were observed. A positive family history of atopy was associated with lower odds of completing H-OIT (odds ratio 0.221, 95% confidence interval 0.055-0.895, p = 0.034).
conclusionH-OIT may be an effective treatment option for children with HA despite the high discontinuation rate. One quarter of patients remained on a lower, partial maintenance dose. Although the overall safety profile of H-OIT seems acceptable, anaphylactic events represent a significant burden for families and must be carefully considered when weighing the risks and benefits of OIT.
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