Allergy to apples in adults
Fruits are necessary for all people, regardless of age. But sometimes people are faced with an extremely unpleasant phenomenon – an allergy to apples in adults. It occurs in people who suffer from pollinosis and manifests itself mainly in the oral cavity.

If a person suffers from hay fever (allergic rhinitis), which is caused by pollen, then even ordinary, well-known and familiar apples from childhood can become dangerous for him. When used, the mouth or throat may itch or swell, itch, and become inflamed. It occurs in 50-75% of adults who are allergic to birch pollen. This reaction occurs because the proteins found in some fruits and vegetables (including regular apples) are very similar to the proteins found in pollen.

Apples are considered hypoallergenic foods, especially those that are white, green, or yellow. Fruits with a brighter skin have a slightly higher allergenic potential, but still rarely provoke true allergic reactions as a food. Most often, reactions occur as a variant of cross-allergy in people who suffer from hay fever – an allergic reaction to the pollen of weeds, plants or trees, which occurs during the flowering and pollen release period: from mid-spring to mid-summer (in some regions and longer) .

Can adults be allergic to apples?

Allergic reactions to eating apples can occur at any age, even if a person has been quietly eating these fruits for many years without any reactions. Such an allergy occurs as a cross-reaction. Apples contain protein compounds that are similar in chemical structure to pollen proteins, so reactions are possible during an exacerbation of hay fever or in other months when people consume apples.

These similar proteins can confuse the immune system and cause an allergic reaction or aggravate existing symptoms, which is called cross-reactivity. In the case of pollen and food, the result of cross-reactivity is called oral allergy syndrome (OSA), also known as fruit-pollen syndrome (in English, it is referred to in the literature as PFS).

How does an allergy to apples manifest in adults?

Oral allergy syndrome is a form of contact allergic reaction that occurs when the mouth and throat come into contact with raw fruits or vegetables, including different varieties of apples. The most common symptoms of OSA include itching or swelling of the mouth and gums, face, lips, tongue, and throat.

Symptoms usually appear immediately after eating raw fruits or vegetables, although in rare cases it may take more than an hour for a reaction to appear. Oral allergy syndrome is usually considered a mild form of food allergy. In rare cases, OSA can cause severe swelling in the throat, leading to difficulty swallowing or breathing. A person with a severe allergy develops a so-called systemic reaction or anaphylaxis. It can be caused by cross-reactions between pollen and components of raw fruits or vegetables, but this is very rare. This reaction can occur at any time of the year.

Some people report symptoms when they eat just one food, apples, while others suffer from allergies to many different fruits and vegetables. Some people report that only certain varieties of fruits, such as certain varieties of apples, cause symptoms. In OAS, people react to different foods depending on what type of seasonal allergy they are suffering from.

For example, if a person is allergic to birch pollen, a major airborne allergen that causes symptoms in the spring, they may have reactions to apples and other pitted fruits or carrots. Even peanuts, almonds, hazelnuts can cause itchy mouths in people allergic to birch pollen. If your mouth is itchy after eating apples of any variety, you should see an allergist or immunologist, as mild mouth symptoms may indicate a more severe allergic reaction to other allergens.

People with grass allergies may have reactions to red apples, peaches, celery, tomatoes, gourds (melon, watermelon, and pumpkin), and oranges. Those who have a reaction to ragweed may experience symptoms when eating foods such as banana, cucumber, melon, and zucchini.

How to treat an allergy to apples in adults

Any unpleasant symptoms from the skin, mouth, lips or tongue should be the reason for contacting an allergist. This is especially important for people suffering from hay fever.

Diagnostics

Usually the diagnosis is determined according to the clinical examination, taking into account the complaints that patients present. Although there is no definitive test for oral allergy syndrome, affected individuals often have a positive allergy skin test (skin tests) or blood tests for a particular pollen (high levels of specific immunogloublins E), along with a history of symptoms after ingestion of suspect foods (varieties of apples). ).

Modern methods

If a person has symptoms of an oral allergy, they should avoid dangerous raw foods (apples, juice from them), especially during allergy season, because in many patients OSA worsens during the season of the pollen in question.

One way to reduce food cross-reactions is to bake or microwave your meal with apples, because the high temperatures destroy the proteins responsible for the development of the syndrome. Canned foods can also limit the reaction. It may also be helpful to peel the skins of apples before eating, as the harmful protein is often concentrated in the skins.

Some studies have shown that immunotherapy treatment (allergy shots) can improve OAS symptoms.

The patient should talk to their doctor if:

  • oral allergy symptoms cause significant discomfort in the throat;
  • manifestations gradually worsen;
  • complaints caused by cooked fruits and vegetables;
  • oral allergy symptoms other than apples are caused by nuts;
  • develop systemic reactions after eating raw fruits or vegetables, such as hives, vomiting, or difficulty breathing.

Prevention of apple allergy in adults at home

The best prevention option is to stop eating raw apples. They can be used after heat treatment, in the form of jam, preserves. If you want fresh apples, you need to peel them and try a small piece, tracking reactions throughout the day. If everything went well, you can increase the dose to 1 – 2 apples a day gradually.

Popular questions and answers

Answered questions about allergy to apples allergist-immunologist of the highest category, Ph.D. Ksenia Bocharova.

Can there be complications with an allergy to apples?
Most often, “allergy to apples” occurs as part of the oral allergy syndrome. Oral Allergy Syndrome is a perverse way the immune system reacts to the allergen protein particles that make up the apple. Usually, immediately at the time of eating an apple or shortly after, an allergic person feels tingling of the tongue, lips, sore throat, swelling of the lips, tongue, pharynx, a feeling of lack of air and, in extreme cases, loss of consciousness. Usually symptoms develop immediately, or at most within an hour or two after eating an apple.
Are apple allergies common?
In itself, the condition “oral allergy syndrome with sensitization to an apple” is extremely rare, I have not met such patients in 15 years of work. Usually associated with birch allergy in cross-reactions: allergic rhinitis or asthma with birch sensitization in combination with oral allergy syndrome (apples and some other stone fruits).
How to replace apples with allergies?
Usually, when apple oral allergy syndrome occurs, apples should be completely avoided due to an increased risk of developing acute reactions with swelling of the larynx or pharynx (suffocation), which requires emergency medical attention. The patient is allowed to consume products to which there is no sensitization. The list of products is determined individually after examination using molecular allergodiagnostics using the ImmunoCAP method.

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