Local fruit varieties, specifically pineapple, banana, and mango, have been identified as the most common local fruit varieties suspected to cause allergies.
These findings were made in a poster presentation on the “Presentation of allergies to local fruits at an immunology clinic in Sri Lanka” which was authored by T.N.D. Ranasinghe, A.M.I.S. Aberathna, M.P.D.J. Jayamali, P.H.Chathurangika, G.N. Malavige, and J.M.K.C. Jeewandara (all six attached to the University of Sri Jayewardenepura’s Faculty of Medical Sciences’ Department of Immunology and Molecular Medicine’s Allergy, Immunology, and Cell Biology Unit) and published as an abstract in September of this year in the first Supplement of the 55th volume of the Journal of the Ceylon College of Physicians as part of the 2023 annual academic sessions of the college.
There is very limited data in Sri Lanka on the most frequent type of fruit allergens that give rise to allergies.
Therefore, Ranasinghe et al. sought to investigate the type of fruits leading to allergies in patients at an immunology referral clinic. The data from 130 patients who presented with a history of allergy to fruits at the clinic of the said Allergy, Immunology, and Cell Biology Unit were evaluated. As a part of their management, skin prick testing using commercial allergens or the fresh fruit itself (prick to prick) was done according to a World Allergy Organisation position paper of 2020.
Out of the 130 patients with a suspected fruit allergy, 79/60.8% were female and 84/64.6% were adults. A total of 26/20% of the patients reported an episode of anaphylaxis (an acute allergic reaction with multi-system involvement that can present as, or rapidly progress to, a life threatening reaction, and which may occur following exposure to a variety of allergen triggers including food, insect venom, drugs, and vaccines) following the consumption of the fruit. The most common local fruit varieties suspected to cause allergies are pineapple (79.2%), banana (10%) and mango (9.2%). Of the suspected fruit allergens, 52/40% were confirmed by the skin prick test. The most frequent allergens that were confirmed were pineapple (32/61.5%), banana (eight/15.4%), and mango (three/5.8%). Of these patients, 23 presented with suspected multiple fruit allergies, and by the skin prick test, nine/39.1% were confirmed to have a fruit allergy to one or two fruits.
Local fruit varieties can be causative agents for allergic reactions. Pineapple seems to be the most common allergen. Hence, it is important for physicians to be aware of fruit based allergies when evaluating patients presenting with food allergies and should refer such patients for confirmatory testing and patient education.