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Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo).

Abstract

BACKGROUND

Few studies have evaluated IgE-mediated hypersensitivity to melon with details of clinical reactions confirmed by double-blind, placebo-controlled, food challenges (DBPCFCs).

OBJECTIVE

We sought to investigate clinical features (type and severity of reactions, age at onset, results of skin prick and in vitro tests, and incidence of other allergic diseases and associated food allergies) of acute allergic reactions to melon confirmed by DBPCFCs.

METHODS

Fifty-three consecutive adult patients complaining of adverse reactions to melon were included in the study. Skin prick tests and detection of specific IgE were performed in all patients with melon, avocado, kiwi, banana, chestnut, latex, pollen, and other offending foods. Patients first underwent an open food challenge, unless they had a convincing history of severe anaphylaxis. Positive open food challenge reactions were subsequently evaluated by DBPCFCs.

RESULTS

Actual clinical reactivity was confirmed in 19 (36%) of 53 patients. The most frequent symptom was oral allergy syndrome (n = 14), but two patients experienced life-threatening reactions, including respiratory symptoms and hypotension. The positive predictive value for a skin prick test was 42%, and that for specific IgE measurement was 44%. Forty-five reactions to 15 other foods were confirmed in 18 patients. The most common foods associated with melon allergy were avocado (n = 7), banana (n = 7), kiwi (n = 6), watermelon (n = 6), and peach (n = 5). Onset of melon-induced allergic symptoms occurred from 6 to 45 years (median, 20 years), preceded by seasonal rhinitis, asthma, or both in 88% (15/17).

CONCLUSION

About one third of reported reactions to melon are confirmed by means of DBPCFC, which has been proven to be the most reliable procedure in the diagnosis of clinical fruit allergy. Isolated melon allergy is rare, with most patients either having allergic rhinitis, asthma, or both and associated food allergies.

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  • Authors+Show Affiliations

    ,

    Servicio de Alergia, Hospital Universitario Doce de Octubre, Madrid, Spain.

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    Source

    MeSH

    Adolescent
    Adult
    Age of Onset
    Cross-Over Studies
    Double-Blind Method
    Food Hypersensitivity
    Fruit
    Humans
    Middle Aged

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    11080722

    Citation

    Rodriguez, J, et al. "Randomized, Double-blind, Crossover Challenge Study in 53 Subjects Reporting Adverse Reactions to Melon (Cucumis Melo)." The Journal of Allergy and Clinical Immunology, vol. 106, no. 5, 2000, pp. 968-72.
    Rodriguez J, Crespo JF, Burks W, et al. Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). J Allergy Clin Immunol. 2000;106(5):968-72.
    Rodriguez, J., Crespo, J. F., Burks, W., Rivas-Plata, C., Fernandez-Anaya, S., Vives, R., & Daroca, P. (2000). Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). The Journal of Allergy and Clinical Immunology, 106(5), pp. 968-72.
    Rodriguez J, et al. Randomized, Double-blind, Crossover Challenge Study in 53 Subjects Reporting Adverse Reactions to Melon (Cucumis Melo). J Allergy Clin Immunol. 2000;106(5):968-72. PubMed PMID: 11080722.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). AU - Rodriguez,J, AU - Crespo,J F, AU - Burks,W, AU - Rivas-Plata,C, AU - Fernandez-Anaya,S, AU - Vives,R, AU - Daroca,P, PY - 2000/11/18/pubmed PY - 2001/2/28/medline PY - 2000/11/18/entrez SP - 968 EP - 72 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 106 IS - 5 N2 - BACKGROUND: Few studies have evaluated IgE-mediated hypersensitivity to melon with details of clinical reactions confirmed by double-blind, placebo-controlled, food challenges (DBPCFCs). OBJECTIVE: We sought to investigate clinical features (type and severity of reactions, age at onset, results of skin prick and in vitro tests, and incidence of other allergic diseases and associated food allergies) of acute allergic reactions to melon confirmed by DBPCFCs. METHODS: Fifty-three consecutive adult patients complaining of adverse reactions to melon were included in the study. Skin prick tests and detection of specific IgE were performed in all patients with melon, avocado, kiwi, banana, chestnut, latex, pollen, and other offending foods. Patients first underwent an open food challenge, unless they had a convincing history of severe anaphylaxis. Positive open food challenge reactions were subsequently evaluated by DBPCFCs. RESULTS: Actual clinical reactivity was confirmed in 19 (36%) of 53 patients. The most frequent symptom was oral allergy syndrome (n = 14), but two patients experienced life-threatening reactions, including respiratory symptoms and hypotension. The positive predictive value for a skin prick test was 42%, and that for specific IgE measurement was 44%. Forty-five reactions to 15 other foods were confirmed in 18 patients. The most common foods associated with melon allergy were avocado (n = 7), banana (n = 7), kiwi (n = 6), watermelon (n = 6), and peach (n = 5). Onset of melon-induced allergic symptoms occurred from 6 to 45 years (median, 20 years), preceded by seasonal rhinitis, asthma, or both in 88% (15/17). CONCLUSION: About one third of reported reactions to melon are confirmed by means of DBPCFC, which has been proven to be the most reliable procedure in the diagnosis of clinical fruit allergy. Isolated melon allergy is rare, with most patients either having allergic rhinitis, asthma, or both and associated food allergies. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/11080722/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(00)24870-7 DB - PRIME DP - Unbound Medicine ER -