Abstract

Pink peppercorn is a spice produced by Schinus terebinthifolius, a shrub of the Anacardiaceae family which is used in culinary preparations. We report the case of an 18-year-old patient with a history of cashew nut allergy who presented several reactions with a 5-berry pepper containing pink peppercorns. There are cross-reactivities within the Anacardiaceae family, which includes cashew nuts, pistachios, mangoes and pink peppercorns. This is explained by a structural similarity between these different proteins, especially the cashew nut and pistachio proteins: Ana o 1/Pis v 3, Ana o 2/Pis v 2 and Ana o 3/Pis v 1. In literature reactions have also been reported between cashew and other tree nuts, peanuts, sumac, citrus fruits, fruits (mango, kiwi, red pitaya, cashew apple). These cross-reactivities must be systematically looked for when questioning to avoid further anaphylaxis.

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