post-title Oral Allergy Syndrome 2013-04-25 14:05:22 yes no Posted by

Oral Allergy Syndrome

by Dr. Grace Ryu, M.D. Have you ever experienced an itchy mouth or throat after eating raw apples or banana?  If you have experienced those symptoms and also have allergic rhinitis (hay fever) then you probably have “oral allergy syndrome”. I developed these symptoms in my mid 20’s and didn’t realize the link to my […]

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GraceRyu-300x285by Dr. Grace Ryu, M.D.

Have you ever experienced an itchy mouth or throat after eating raw apples or banana?  If you have experienced those symptoms and also have allergic rhinitis (hay fever) then you probably have “oral allergy syndrome”. I developed these symptoms in my mid 20’s and didn’t realize the link to my pollen allergies until I was in my allergy training.

This reaction is caused by an allergic response to the proteins in some fruits and vegetables that are similar to those found in certain pollens.  The cross-reactivity occurs typically in the oral mucosa (lining of the mouth) because your immune system thinks it is the pollen.  Most symptoms consist of itchiness or swelling of the mouth, lip or throat. It is very rare (less than 2%) to develop generalized anaphylactic symptoms.  Usually symptoms start immediately after eating raw fruits or vegetables and will not persist for hours.  Typically no treatment is necessary.

There is no definitive test for the syndrome.  Often the diagnosis is made by skin prick testing for specific pollens and by a corresponding history of symptoms with specific fruits or vegetables.

Oral allergy syndrome can occur anytime of year but for some people it only occurs during spring and fall. Most people can eat the fruit or vegetable if cooked or canned since this breaks down the offending protein.  Occasionally peeling the skin off of fruit will help.  In people with severe oral allergy syndrome, immunotherapy to the pollens can help.  Immunotherapy helped my ragweed symptoms and now I can eat bananas and melons without problems.

Below is a list of pollens and the cross-reactive foods: (One should note that not every person allergic to pollens develops symptoms and a person with oral allergy syndrome may not react to all the foods similar to the pollen.)

Ragweed:  Bananas, melons (watermelon, cantaloupe, honeydew), zucchini, kiwi, cucumber, dandelions, chamomile tea.

Birch tree: Apples, pears, peaches, apricots, cherries, plums, nectarine, prunes, kiwi, carrots, celery, potatoes, peppers, fennel, parsley, coriander, parsnips, hazelnuts, almonds, walnuts

Grass: Peaches, celery, melons, tomatoes, oranges.

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