Fruit and vegetable allergy in children

Abstract

Rationale Fruit and vegetable allergy is common in pollen allergic adults. We sought to characterize plant food allergy in children. Methods Chart reviews of children with fruit/vegetable allergy evaluated at Mount Sinai Allergy Clinic from 2000 to 2002 and telephone interviews were performed. Results Ninety five patients were identified, and 69 were enrolled. Participants were median 11 years old (range, infancy to 18), reported onset of fruit/vegetable allergy at a median age of 5 years (range, infancy to 16) and reacted to a median of 5 fruits/vegetables (range, 1 to 20). A total of 383 fruit/vegetable reactions were reported; 52% occurred to foods typically associated with birch (apple, carrot, peach) and 33% with ragweed pollen (cantaloupe, banana, honeydew). Symptoms were predominantly limited to oropharyngeal mucosa but progression was reported in 4 children; 2 developed respiratory or cardiovascular reactions to carrots, 1 had generalized urticaria to carrot, broccoli and cauliflower, and 1 developed severe throat angioedema to tomato. Additionally, 9 children reported 14 initial systemic reactions to 11 foods, 5 of which do not have a well established cross-reactivity with pollen. Generalized urticaria occurred in 10 reactions, 1 also associated with cough. Respiratory and cardiovascular symptoms occurred in 4 reactions, one of which was caused by carrot. Conclusions Fruit/vegetable allergy in children is similar to that in adults; symptoms are generally mild and associated with pollen-rhinitis. Systemic reactions occur rarely and may be more common with carrot and with foods not classically cross-reactive with pollen.