Oral Allergy Syndrome

[Spryte]

Care to share info?  

 

DS has it, and can't eat most fruits of veggies raw.  His allergist has talked to us about it, and we avoid the raw fruits/veggies that cause reactions.  I didn't realize that it could turn into anaphylaxis, and occasionally will give him a fruit that he's reacted to in the past - sometimes he seems to tolerate it (grapes, in this case), sometimes it makes him itch.  I will ask the allergist about it at the next visit, but obviously I haven't been taking OAS as seriously as his other IgE allergies which have caused anaphylaxis.  This might be a mistake.  I'm realizing this thanks to another board member here.  (Thanks!)

 

Not taking it seriously really doesn't make sense, since my mom has had allergies to raw fruits and veggies most of her life, and has almost died repeatedly.  Clearly, her allergies are OAS because she can eat the same fruits and veggies if they are cooked with no problems.  She just didn't know the words "Oral Allergy Syndrome" as a child, and just knew she was allergic.  I should have made the connection there!

 

How common is anaphylaxis from OAS?  Do those of you with OAS carry an epipen?  Why would he react to grapes sometimes and not others?  (I'm thinking it has to do with the amount of pollen in the air that cross reacts with grapes?)  Do you ever eat your OAS fruits or veggies and just take Benadryl?  

 

DS had a well child visit a few days ago, and I asked the pediatrician - she had never even heard of Oral Allergy Syndrome.  I don't know if this means we should look for another pedi, or if OAS is just so uncommon or new that she doesn't know about it.  

 

Please - fill me in!

 

I'm comfy with nut, seed, wheat, dairy allergies.  But this OAS business has me scratching my head.

[Cindy in FL.]

I'm watching this thread with interest as my ds14 has this with many fruits. Usually it's not a big deal if he does eat something, he just gets an itchy throat. But, recently he said it felt like his throat was closing up. Now I don't feel as comfortable with it.

[Momof3littles]

Watching as well. I suspect my DS1 may have this. He gets itchy from almonds and peaches, which I've read are common culprits in OAS. No hives, nothing anywhere else on his body, just itchy around his mouth I think. Of all my kids he also seems to be the most sensitive to pollen, which I've read is intertwined with OAS?

[Mergath]

I'm no OAS expert, but different varieties of fruit and vegetable can cause variable reactions because they don't all have the same amount of the stuff in them that causes the reaction.  Some people can eat some varieties of apple, for example, but not others.  Also, reactions tend to be worse during allergy season.

 

I've never had an anaphylactic reaction, but my doctor did recommend that I carry an epi pen.  I haven't gotten one yet because they're expensive, but I'm supposed to have one.  And you might want to look for a different pedi.  My doctor is just your standard family doctor, and he knew all about OAS.

[Spryte]

Watching as well. I suspect my DS1 may have this. He gets itchy from almonds and peaches, which I've read are common culprits in OAS. No hives, nothing anywhere else on his body, just itchy around his mouth I think. Of all my kids he also seems to be the most sensitive to pollen, which I've read is intertwined with OAS?

That almond reaction warrants some allergy testing, I think. :(

[Spryte]

I'm watching this thread with interest as my ds14 has this with many fruits. Usually it's not a big deal if he does eat something, he just gets an itchy throat. But, recently he said it felt like his throat was closing up. Now I don't feel as comfortable with it.

Yes, that's what my mother describes. And that's what DS feels at the start of anaphylaxis.

 

OAS is more worrisome than I thought.

 

Do you have an epipen?

[Karen in CO]

Just a note - cooking doesn't classify something as "Not a real allergy."  Cooking fruits and vegetables changes them so that a person may not be allergic or as allergic to them any more.  OAS doesn't cause anaphylaxis, but allergies can cause an itchy mouth and throat.  

 

Here are some anecdotes to illustrate:

 

I'm terribly allergic to ragweed.  I get hives when I touch it, and it makes late summer and fall miserable.  Because of my ragweed allergy, I can't eat melons - they make my mouth itch, and I will get the equivalent of oral hives if I insist on eating it.  It never bothers my asthma or causes my throat to swell.  

 

My dd tested negative to all tree nut allergies two years ago, but they made her mouth itchy.  Her allergist warned us to not dismiss it as OAS.  Six months later, she ate a cookie with walnuts in it at a Christmas party.  Before she could swallow it, her mouth started itching.  Her tongue started swelling.  She then broke out in hives and felt like she was having an asthma attack.  We gave her her epi-pen and rushed her to the ER.  She had to have a second dose of epinephrine and spent 8 hours in the ER trying to keep her blood pressure stable.  The next week, the same thing happened with a brownie.  That is a life-threatening allergy.

 

My youngest is allergic to tomatoes according to her scratch test.  If she touches a raw tomato, she gets itchy.  If she eats something with raw tomatoes in it, she will break out in terrible eczema.   However, I can make her a long-simmered tomato sauce that doesn't bother her at all.  The part of the tomato she's allergic to changes when it is cooked. She is allergic to tomatoes.

 

OAS is a real thing, but it is related to other known allergies.  An itchy mouth isn't what determines whether a reaction is due to OAS or an allergy.

[mommymilkies]

I have OAS with kiwi.  Actually, it seems to have progressed as it now also gives me ulcer-like stomach pain. 

[Spryte]

I'm no OAS expert, but different varieties of fruit and vegetable can cause variable reactions because they don't all have the same amount of the stuff in them that causes the reaction. Some people can eat some varieties of apple, for example, but not others. Also, reactions tend to be worse during allergy season.

 

I've never had an anaphylactic reaction, but my doctor did recommend that I carry an epi pen. I haven't gotten one yet because they're expensive, but I'm supposed to have one. And you might want to look for a different pedi. My doctor is just your standard family doctor, and he knew all about OAS.

Oh, I wonder if DS is reacting to different varieties of grapes? Hmmmm.

 

Hey, there's a coupon on the epipen site that will cover your copayment for epipens, Mergath. I will try to find a link for you when not on the phone. Might cover it if you don't have insurance, too!

[Spryte]

Thanks, Karen, your post is helpful.

 

How does one determine, then, whether it's OAS or a true allergy? Or is that even important? We can do SPT or bloodwork with the allergist, obviously, or just run with the history of reactions.

 

How on earth does one fit everything on a medic alert bracelet??? Seriously, my kiddo is allergic to the air, at this point. :(

[Spryte]

I have OAS with kiwi. Actually, it seems to have progressed as it now also gives me ulcer-like stomach pain.

Yikes.

[mommymilkies]

Thanks, Karen, your post is helpful.

 

How does one determine, then, whether it's OAS or a true allergy? Or is that even important? We can do SPT or bloodwork with the allergist, obviously, or just run with the history of reactions.

 

How on earth does one fit everything on a medic alert bracelet??? Seriously, my kiddo is allergic to the air, at this point. :(

My doctor diagnosed it on symptoms-my mouth goes numb and tingly and then painful with kiwi.  She said it wasn't worth a trip to an allergist.  Just avoid kiwi.  If it was more severe, she would send me.

[Karen in CO]

Thanks, Karen, your post is helpful.

 

How does one determine, then, whether it's OAS or a true allergy? Or is that even important? We can do SPT or bloodwork with the allergist, obviously, or just run with the history of reactions.

 

How on earth does one fit everything on a medic alert bracelet??? Seriously, my kiddo is allergic to the air, at this point. :(

 

From WebMD:

In oral allergy syndrome, your immune system treats proteins similar to those in pollen that are sometimes found in fruits or vegetables the same way. It's as if it says, "Close enough!" and attacks it. That's called cross-reactivity.

 

 

 

 

Foods to Watch Out For

Ragweed Allergy: "Ragweed, in theory, cross-reacts with bananas and melons, so people with ragweed allergies may react to honeydew, cantaloupe, and watermelons, or tomatoes," says Warren V. Filley, MD, from the Oklahoma Allergy & Asthma Clinic in Oklahoma City.

Zucchini, sunflower seeds, dandelions, chamomile tea, and echinacea also go on that list.

Birch Pollen Allergy: People with birch pollen allergies may react to kiwi, apples, pears, peaches, kiwi, plums, coriander, fennel, parsley, celery, cherries, carrots, hazelnuts, and almonds.

Grass Allergy: People with grass allergy may react to peaches, celery, tomatoes, melons, and oranges, according to the AAAAI.

Latex Rubber Allergy: Like pollen allergy, people allergic to latex rubber may react to bananas, avocados, kiwi, chestnut, and papaya.

Oral Allergy Syndrome Test

Hannelore A. Brucker, MD, of the Southdale Allergy & Asthma Clinic in Minneapolis, often asks her allergy patients about possible oral symptoms.

"I ask if they have itching in the mouth when they eat apple, and if they say 'No' and then I see a skin test and it’s high-positive for birch, I ask again," says Brucker.

 

 

I test positive to ragweed and negative to watermelon  so my itchy mouth after eating watermelon is because I'm allergic to ragweed.   My older dd tested positive to birch (and every other tree imaginable) and negative to almonds, but her tree reactions were so severe, her allergist said that the almond allergy could be still developing.  She now tests positive to all trees and all tree nuts, not just almonds.    My younger is allergic to grass and tomatoes.  Out of the three of us, I am the only one with OAS even though we all have foods that make our mouth itchy.  I don't think I'd ever attribute a child's itchy mouth to OAS.  I am comfortable with my OAS because my allergies have been the same for 30 years.  

 

 

and btw - my dd's medic alert bracelet just says anaphylactic allergies.  The child is even allergic to wallabies.  

[Spryte]

I don't think I'd ever attribute a child's itchy mouth to OAS. I am comfortable with my OAS because my allergies have been the same for 30 years.

 

 

and btw - my dd's medic alert bracelet just says anaphylactic allergies. The child is even allergic to wallabies.

This makes sense to me.

 

I remember the wallaby allergy. :) ...so you don't list individual allergens? That's a good idea - thank you!