The case report by Phan et al1 of transfer of nut allergy is interesting from the phenomenological standpoint and also serves as a haunting lesson in the proper management of patients with food allergy. It has been suggested that some transplantation drugs (tacrolimus) play an immunopathogenetic role in the development of food allergy by driving a TH2 response.2 It appears from this case as well that aggressive immunosuppression does not temper the clinical manifestations of anaphylaxis.
Stadtmauer G. Food Allergy: Preventing a Fatal Outcome. Arch Intern Med. 2003;163(15):1861–1862. doi:10.1001/archinte.163.15.1861-a