İstanbul Medical Journal (Nov 2021)
A Patient Having Multiple Fruit-Vegetable Allergies Presenting with Abdominal Pain
Abstract
Allergy to fruits and vegetables are the most frequent food allergies in adolescents and adults. The most common phenotypes of fruit and vegetable allergy are pollen-food allergy syndrome (PFAS) (oral allergy syndrome) and lipid transfer protein (LTP) syndrome. In PFAS, fruit and vegetable allergy is caused by a prime sensitization to labile pollen allergens, e.g. Bet v 1 or profilin, and yielding generally mild phenotype, is made of local oropharyngeal symptoms. However, LTP syndrome occurs from a sensitization to LTPs, which are stable plant food allergens, often resulting systemic allergic reactions and moreover anaphylaxis. Component-resolved molecular diagnosis is crucial in directing the treatment of these patients. Existing therapeutic policies involve prevention and salvage medication, including epinephrine, for life-threatening LTP allergic reactions. Allergen specific pollen immunotherapy is not found to be helpful to manage PFAS, nevertheless sublingual immunotherapy against LTPs appears to be an encouraging treatment. Here, an interesting patient having abdominal pain for a long period of time whom later diagnosed by us with PFAS is discussed under the light of recent literature.
Keywords