Pili nut allergy

I also was not able to locate any information about pili nuts. These nuts are primarily from Southeast Asia. The edible seed is a ‘drupe’, a seed contained within a pit or stone that is surrounded by a fleshy fruit. Other drupes include cashew and almond, which do not cross react. Pili nuts are from the genus Canarium, and the only other edible seeds I could find in this genus are Chinese olives and canarium nut. It would seem unlikely from a botanical perspective that pili nuts would pose a threat other than individuals with one food allergy are more likely to have other food allergies.

I shared your question with Dr. Scott Sicherer, an international expert in food allergy. His response is below.

I am not aware of reports of pili nut allergy. I have actually not had anyone ask. Like you, I was unable to locate reports on allergy or allergenicity. They may be in the literature and just not easily found, and we both missed it.

I would assume an allergy is possible since it is a plant material and presumably its protein can trigger immune responses. It seems inevitable that some allergy has or will be in the literature. My advice to be cautious or to go ahead and eat it would likely depend on the specifics of the allergy of the patient asking.

If it were my patient, I would discuss their motivation to eat it, consider the severity of their other allergies and any cross-contact issues in obtaining the Pili nut, and consider whether a prick-prick skin test might be considered ahead of gradually trying it. If strongly motivated despite a positive skin test (assuming skin testing was decided upon), then an oral food challenge may be considered.

Sincerely,
Dr. Scott Sicherer

I hope this information is of help to you and your practice.

All my best.
Dennis K. Ledford, MD, FAAAAI