“How should I deal with my daughter's oral allergy to apples?”
My daughter is suffering from a weird oral allergy that is triggered by consumption of apples. What is the best way to get rid of this allergy or does it mean I should completely cut out apples from her diet?
4 Answers
Avoid apples which have cross reacting protein with trees. Cook the apple and denture the protein and she will be able to eat.
Cook the apple and she will be able to tolerate it.
Talal M. Nsouli, M.D., FACIP, FACAAI, FAAAAI
Talal M. Nsouli, M.D., FACIP, FACAAI, FAAAAI
Unfortunately, your daughter is not alone. Oral allergy syndrome with fresh fruits and vegetables is quite common. It results from cross reacting proteins found in certain pollens (Birch tree, ragweed, mugworth and Timothy grass being the main ones) and those fruits and vegetables. While this oral allergy carries negligent risk for systemic reactions and normally does not require Epinephrine device, the symptoms can be quite bothersome and include itching, during, mild swelling or hives. They are usually self limited and resolve without intervention though oral antihistamines may prove helpful. There is no direct treatment for this allergy - we generally recommend avoidance of the offending fruit or vegetable but those can safely be eaten in a cooked form. So fruits from cups, cans and in baked goods as well as apple sauce or juice will be tolerated. Some patients who choose to undergo immunotherapy (allergy shots) for their inhalant allergies may see an improvement or sometimes complete resolution of the oral allergy symptoms though this is not the outcome for everyone.
So, in a few words, she can safely eat cooked forms of apples but I would advise avoiding raw/fresh apples for now and any other fresh fruits/veggies that trigger similar symptoms in the future.
Hope that helps.
Monika Korff, MD
So, in a few words, she can safely eat cooked forms of apples but I would advise avoiding raw/fresh apples for now and any other fresh fruits/veggies that trigger similar symptoms in the future.
Hope that helps.
Monika Korff, MD
Hi,
Your daughter could certainly have a true allergy to apple, but it is more likely that she has “oral allergy syndrome” (OAS). OAS occurs because pollen proteins can sometimes cross-react with proteins found in raw fruits and vegetables. Most patients with oral allergy syndrome will have some pollen sensitivity and will only react to raw fruits and vegetables. Cooking or baking the fruit or vegetable, in question, usually removes the oral irritation. Please note that OAS is benign; unlike true food allergy, there is not generally thought to be a risk of anaphylaxis with oral allergy syndrome. An allergist can help your daughter differentiate between oral allergy syndrome and true food allergy. The patients that I see with oral allergy syndrome generally fall into two groups. One group will continue to eat foods in question because they really like the food and they are willing to put up with some oral discomfort. The second group of people are quite bothered by the oral irritation and will refuse to eat the food!
Your daughter could certainly have a true allergy to apple, but it is more likely that she has “oral allergy syndrome” (OAS). OAS occurs because pollen proteins can sometimes cross-react with proteins found in raw fruits and vegetables. Most patients with oral allergy syndrome will have some pollen sensitivity and will only react to raw fruits and vegetables. Cooking or baking the fruit or vegetable, in question, usually removes the oral irritation. Please note that OAS is benign; unlike true food allergy, there is not generally thought to be a risk of anaphylaxis with oral allergy syndrome. An allergist can help your daughter differentiate between oral allergy syndrome and true food allergy. The patients that I see with oral allergy syndrome generally fall into two groups. One group will continue to eat foods in question because they really like the food and they are willing to put up with some oral discomfort. The second group of people are quite bothered by the oral irritation and will refuse to eat the food!
