Syn .: OAS (oral allergy syndrome), oral allergy syndrome (UZU), oral allergy syndrome, oral local anaphylaxis, oral anaphylaxis, perioral allergic syndrome, Amlot-Lessof syndrome, allergic stomatitis syndrome.
Def .: A complex of symptoms consisting in the occurrence of swellings within the mucous membranes of the mouth and lips or contact urticaria in a different location after eating or only touching a specific food in people previously allergic to pollen of trees, associated with clinical symptoms of seasonal allergic rhinitis. Symptoms occur after consumption of foods that cross-react with tree pollen allergens in patients allergic to these pollen. The first description of the OAS was made by Amlot in 1989.
Epid .: Difficult to define.
Etiol .: The mechanism of the disease consists mainly of cross-reactions between the proteins of tree pollen allergens and fruit, vegetables, nuts and spices. It is an immediate, IgE-mediated allergic reaction. It concerns patients who already suffer from IgE-dependent allergy – most often it is allergic rhinitis or atopic dermatitis. Allergens that play a role in the development of OAS are panallergens, proteins with a molecular weight of 14 to 18 kDa found in plant pollen and many fruits and vegetables. In Polish conditions, cross reactions between birch pollen and apple or hazelnuts are most often observed, followed by: hazel pollen and hazelnuts or walnuts, mugwort pollen and celery. Among other tree pollen, alder, oak, beech and ash pollen are mentioned. Other fruits and vegetables include pears, plums, peaches, cherries, carrots, and potatoes. Initially, due to the heat-labile (thermolabile) nature of allergens, patients may consume food after its earlier processing (cooking, frying, etc.), and only have a bad tolerance for raw food. After some time, they also start to sensitize heat-resistant (thermostable) allergens, patients also start to tolerate processed foods (fried, boiled, baked) poorly. The period between the onset of allergic rhinitis and the development of OAS may last from several weeks to even several years.
Clin. Symptoms include: contact urticaria (most often in the first stage of the disease), swelling of the lips, swelling of the mucous membranes of the mouth, throat, tongue, and sometimes also the respiratory tract. The swelling is accompanied by itching and burning symptoms. The skin and mucosal symptoms are accompanied by hay fever.
DL: Skin prick tests, determination of the levels of total and antigen-specific IgE antibodies in the blood serum in relation to plant pollen allergens and food allergens. In addition, specific provocation tests with suspect food may also be performed.
Treatment: Prophylaxis by avoiding contact with intolerant foods. With an exacerbation of symptoms, antihistamines are used. Specific immunotherapy for pollen allergens may reduce or even abolish OAS-like symptoms.
Lit.: [1] Czarnecka-Operacz M., Jenerowicz D., Silny W.: Oral allergy syndrome in patients with airborne pollen allergy treated with specific immunotherapy. Acta Dermatovenerol Croat 2008, 16(1); 19-24. [2] Nash S., Burks A.W.: Oral allergy syndrome. Curr Allergy Asthma Rep 2007, 7(1); 1-2. [3] Tatachar P., Kumar S.: Food-induced anaphylaxis and oral allergy syndrome. Pediatr Rev 2008, 29(4); e23-7.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House
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