Food Allergen Cross-reactivity Tables





Peanut, Tree nut, Sesame, Coconut Cross-reactivity

  • Peanut/tree nut and sesame or coconut cross-reactivity
    • SPT and clinical (by history) cross-reactivity occur between peanuts and tree nuts with sesame but not coconut
      • The proportion of sesame sensitization (by SPT) was 53.3% among peanut sensitive children, 57.7% among tree nut sensitive children, and 68.9% among children sensitized to both peanuts and tree nuts
      • The proportion of clinical (by history) sesame allergy was 13.2% among peanut allergic children, 14.8% among tree nut allergic children, and 50.0% among children allergic to both peanut and tree nuts
    • Coconut classified as a tree nut by the FDA

Seafood Cross-reactivity

Seafood cross-reactivity relationships.png


  • Sicherer:
    • Finned fish: clinical reactions to multiple fish is a common phenomenon, high cross-sensitization rates are even more common, and the allergic reactions tend to be severe
    • Crustaceans: increased risk of cross-reactivity with a potential for severe reactions and a potentially high rate of clinical symptoms, but there are individuals who tolerate most types
    • Mollusk cross-reactivity (between mollusks and mollusks/crustaceans) not well-defined

  • Mite-cockroach-crustacean syndrome
    • Primary sensitization against insect tropomyosins from inhalation, stings or bites could lead to a secondary food allergy to crustaceans ranging from an oral allergy syndrome to anaphylaxis
    • In a study of mostly African American inner-city children, high exposure to cockroach (B. germanica) was significantly correlated with higher shrimp and cockroach IgE levels. In contrast, high exposure to dust mite in the home was highly correlated with IgE levels to D farinae but not with shrimp IgE levels.

Pollen vs Food Cross-reactivity (PFAS or OAS)

Pollen vs Pollen Cross-reactivity

Meat Cross-reactivity