ALLERGY AGAINST EXOTIC FRUITS IN BIRCH POLLEN ALLERGIC PATIENTS. AN INQUIRY STUDY

 Nils E Eriksson, Sonja Werner, Lund, Christian Möller, Umeå, Jan Åke Wihl, Malmö, Kerstin Norrlind, Danderyd Margareta Söderberg, Umeå, Tony Foucard, Uppsala, Jaak Kiviloog, Örebro, Torsten Berg, Västerås and Per Jemsby, Varberg, Sweden

 The majority of Swedish birch pollen (BP) allergic patients report hypersensitivity to some fruits, nuts and vegetables ¹⁾. Some BP-allergic patients complain “I can’t tolerate any fruit“. The main aim of the present study was to answer the question: Can they tolerate any of the exotic fruits, not common in Sweden?

Method. Consecutive patients, having a BP allergy and reporting food hypersensitivity, were asked to fill in questionnaires regarding 66 different fruits and vegetables. The participants were asked to choose one of the following three alternatives as an answer to each of the foods: "I tolerate"; "I get symptoms of"; "I have not tried this food". Skin prick tests were performed with pollen allergens. A total of 397 patients were included in the study.

Results. Most of the patients had experienced reactions to several foods; only 31 patients (8%) reported hypersensitivity to one food only. The number of foods increased with the age of the patients. Some of the fruits had been tried by only very few patients. Fewer than 20% of the patients had tried the following fruits: Salak, Sapodilla, Pitahaya, Yellow granadilla, Mangosteen, Okra, Horned melon, Melon pear, Durian, Guava, Indian fig, Japanese pear, Cherimoya, Rambutan, Tamarillo, Ugli, Pomelo, Kumquat, Ogen melon and Lychee. More than 40% of the patients got symptoms from Hazel nut, Apple, Brazil nut, Walnut, Almond, Peach, Pear, Kiwi, Cherry, Nectarine, Plum, Japanese pear, Pomegranate and Carrot. The following fruits and vegetable were tolerated by more than 80% of the patients who had tried the respective fruit: Fig, Durian, Grape, Yellow granadilla, Kumquat, Okra, Purple granadilla, Persimon, Sapodilla, Banana, Avocado, Cape gooseberry, Date, Cantaloupe, Clementine, Pineapple, Ogen melon, Pitahaya, Indian fig, Papaya, Satsuma, Honey dew melon, Galia melon, Grapefruit, Musk melon, Carambola, Cherimoya, Pepino, Ugli, Mangosteen, Pomelo, Water melon, Rambutan, Lemon, Lychee, Lime, Aubergine, Squash and Salak.

Conclusions. Although allergy to fruits is common among BP allergic patients, there are several easily available fruits which most of the patient tolerate, for instance pineapples, melons, grapes and citrus fruits. Furthermore there are many exotic fruits which most of the patients have not yet tried.

Reference. ¹⁾ Eriksson NE., Formgren H and Svenonius E (1982). “Food hypersensitivity in patients with pollen allergy.” Allergy 37:437-43.  

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Nils E Eriksson
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