Allergy/Immunology

Answer 3 Apple. This patient has a condition known as the “oral allergy syndrome.”While most allergies are considered to be allergen-specific, cross-reactivity between inhaled allergens and some food allergens (eg, oral allergy syndrome) has been well documented. Symptoms include oral pruritus and tingling as well as mild lip swelling. Oral allergy syndrome is an IgE-mediated reaction that occurs when epitopes shared between inhalant allergens and food allergens cross-react. Patients with birch tree pollen allergy may have oral symptoms when eating apples, celery, potatoes, or plums. Patients with ragweed allergy may react to fresh melon or bananas, and individuals with grass pollen allergy may react to raw tomatoes.1 Because digestion and enzymatic degradation occur after ingestion, symptoms are localized to the oropharyngeal mucosa and systemic symptoms are rare. Evaluation by an allergist/immunologist and avoidance of the causative foods is usually recommended. REFERENCES 1. Sampson HA. Update on food allergy. J Allergy Clin Immunol 2004;113:805-19. Click here to return to the questions

Hospital Physician     JCOM     Seminars in Medical Practice Hospital Physician Board Review Manuals About TWC    Subscribe    Contact TWC    Home    Search   Site Map Copyright © 2009, Turner White Communications Updated 1/04/08 • kkj