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Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults.
Clin Exp Allergy 2004; 34(7):1115-21CE

Abstract

BACKGROUND

Allergy to kiwi fruit appears increasingly common, but few studies have evaluated its clinical characteristics, or evaluated methods of investigating the allergy.

OBJECTIVE

To characterize the clinical characteristics of kiwi fruit allergy and to study the role of double-blind placebo-controlled food challenge (DBPCFC), skin tests and specific IgE in the diagnosis of this food allergy.

METHODS

Two-hundred and seventy-three subjects with a history suggestive of allergy to kiwi completed a questionnaire. Forty-five were investigated by DBPCFC, prick-to-prick skin testing with fresh kiwi pulp, and specific IgE measurement. Nineteen subjects were also skin tested using a commercially available solution.

RESULTS

The most frequently reported symptoms were localized to the oral mucosa (65%), but severe symptoms (wheeze, cyanosis or collapse) were reported by 18% of subjects. Young children were significantly more likely than adults to react on their first known exposure (P<0.001), and to report severe symptoms (P=0.008). Twenty-four of 45 subjects (53%) had allergy confirmed by DBPCFC. Prick-to-prick skin test with fresh kiwi was positive in 93% of subjects who had allergy confirmed by DBPCFC, and also in 55% of subjects with a negative food challenge. The commercial extract was significantly less sensitive, but with fewer false-positive reactions. CAP sIgE was only positive in 54% of subjects who had a positive challenge.

CONCLUSIONS

Kiwi fruit should be considered a significant food allergen, capable of causing severe reactions, particularly in young children. DBPCFC confirmed allergy to kiwi fruit in 53% of the subjects tested, who had a previous history suggestive of kiwi allergy. Skin testing with fresh fruit has good sensitivity (93%), but poor specificity (45%) in this population. CAP sIgE and a commercially available skin test solution were both much less sensitive (54%; 75%) but had better specificity (90%; 67%).

Authors+Show Affiliations

Allergy and Inflammation Sciences, University of Southampton, UK. jlucas1@soton.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15248859

Citation

Lucas, J S A., et al. "Kiwi Fruit Is a Significant Allergen and Is Associated With Differing Patterns of Reactivity in Children and Adults." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 34, no. 7, 2004, pp. 1115-21.
Lucas JS, Grimshaw KE, Collins K, et al. Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults. Clin Exp Allergy. 2004;34(7):1115-21.
Lucas, J. S., Grimshaw, K. E., Collins, K., Warner, J. O., & Hourihane, J. O. (2004). Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 34(7), pp. 1115-21.
Lucas JS, et al. Kiwi Fruit Is a Significant Allergen and Is Associated With Differing Patterns of Reactivity in Children and Adults. Clin Exp Allergy. 2004;34(7):1115-21. PubMed PMID: 15248859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults. AU - Lucas,J S A, AU - Grimshaw,K E C, AU - Collins,K, AU - Warner,J O, AU - Hourihane,J O'B, PY - 2004/7/14/pubmed PY - 2004/11/16/medline PY - 2004/7/14/entrez SP - 1115 EP - 21 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 34 IS - 7 N2 - BACKGROUND: Allergy to kiwi fruit appears increasingly common, but few studies have evaluated its clinical characteristics, or evaluated methods of investigating the allergy. OBJECTIVE: To characterize the clinical characteristics of kiwi fruit allergy and to study the role of double-blind placebo-controlled food challenge (DBPCFC), skin tests and specific IgE in the diagnosis of this food allergy. METHODS: Two-hundred and seventy-three subjects with a history suggestive of allergy to kiwi completed a questionnaire. Forty-five were investigated by DBPCFC, prick-to-prick skin testing with fresh kiwi pulp, and specific IgE measurement. Nineteen subjects were also skin tested using a commercially available solution. RESULTS: The most frequently reported symptoms were localized to the oral mucosa (65%), but severe symptoms (wheeze, cyanosis or collapse) were reported by 18% of subjects. Young children were significantly more likely than adults to react on their first known exposure (P<0.001), and to report severe symptoms (P=0.008). Twenty-four of 45 subjects (53%) had allergy confirmed by DBPCFC. Prick-to-prick skin test with fresh kiwi was positive in 93% of subjects who had allergy confirmed by DBPCFC, and also in 55% of subjects with a negative food challenge. The commercial extract was significantly less sensitive, but with fewer false-positive reactions. CAP sIgE was only positive in 54% of subjects who had a positive challenge. CONCLUSIONS: Kiwi fruit should be considered a significant food allergen, capable of causing severe reactions, particularly in young children. DBPCFC confirmed allergy to kiwi fruit in 53% of the subjects tested, who had a previous history suggestive of kiwi allergy. Skin testing with fresh fruit has good sensitivity (93%), but poor specificity (45%) in this population. CAP sIgE and a commercially available skin test solution were both much less sensitive (54%; 75%) but had better specificity (90%; 67%). SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/15248859/Kiwi_fruit_is_a_significant_allergen_and_is_associated_with_differing_patterns_of_reactivity_in_children_and_adults_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0954-7894&amp;date=2004&amp;volume=34&amp;issue=7&amp;spage=1115 DB - PRIME DP - Unbound Medicine ER -