[Oral allergy syndrome in adults of a third level hospital]

Rev Alerg Mex. Apr-Jun 2014;61(2):65-72.
[Article in Spanish]

Abstract

Background: Oral allergy syndrome (OAS) is the mildest form of an allergic reaction to foods. It is characterized by the presence of IgE mediated symptoms restricted to oral mucosa after intake of fresh fruits and vegetables. OAS diagnosis is based on suggestive clinical manifestations and can be confirmed with tests such as prick-to-prick skin test with the food implicated, which have a sensitivity > 90%, specificity 30-60%, positive predictive value (PPV) of 40% and negative predictive value (NPV) > 95%.

Objective: To know the prevalence of OAS in adult patients attending a third level hospital in southern Mexico City, and also describe the demographics of these patients and comorbidities more frequently associated.

Patients and method: We studied 44 patients (40 women and 4 men), with an average age of 33.4 years, with suggestive clinical features of OAS, evaluated with prick-by-prick skin tests with fresh food.

Results: There was a predominance of OAS in woman (91%) and a prevalence of asthma and allergic rhinitis of 54% among this population. We found that 60.4% of these patients had positive prick-by-prick skin tests, being the most frequently involved families of foods: rosaceae (60%), crustaceans (25%), musaceae (23%), actinidacea (21%), lauraceae (16%) and cucurbitaceae (16%). Only 5 patients presented adverse reactions with prick-by-prick skin tests, in 4 of the cases with grade 3 and grade 4 anaphylaxis, while testing with banana-watermelon, peach, papaya and peanut, respectively.

Conclusions: Oral allergy syndrome affects more women than men, the most frequent comorbidities in patients with oral allergy syndrome are allergic rhinitis and asthma, thus, in patients with asthma and allergic rhinitis, sensitized to pollens we have to ask about symptoms suggestive of oral allergy syndrome.

Antecedentes: el síndrome de alergia oral es la forma más leve de una reacción alérgica a alimentos. Se distingue por síntomas restringidos a la mucosa oral, que son mediados por la IgE y generados por la ingestión de frutas frescas y verduras. El diagnóstico de síndrome de alergia oral se establece con un cuadro clínico sugerente y se corrobora con diversos estudios, como las pruebas de Prick-to-Prick a alimentos, que poseen sensibilidad mayor a 90% y especificidad de 30 a 60%.

Objetivo: conocer la prevalencia del síndrome de alergia oral en pacientes adultos atendidos en un hospital de tercer nivel del sur de la Ciudad de México, además de sus características demográficas y comorbilidades asociadas con más frecuencia. PACIENTES Y MÉTODO: estudio prospectivo efectuado con 44 pacientes, 40 mujeres y 4 hombres, con edad promedio de 33.4 años, quienes tuvieron datos clínicos sugerentes de síndrome de alergia oral, y a quienes se realizaron pruebas Prick-to-Prick a alimentos.

Resultados: hubo mayor predominio en mujeres (91%) y prevalencia de asma y rinitis alérgica de 54%. De los pacientes, 60.4% tuvo pruebas positivas Prick-to-Prick a alimentos de las siguientes familias: rosáceas (60%), crustáceos (25%), musáceas (23%), actinidáceas (21%), lauráceas (16%) y cucurbitáceas (16%). Sólo cinco pacientes tuvieron reacciones adversas con las pruebas Prick-to-Prick; en cuatro casos anafilaxia grados 3 y 4 al realizar pruebas con plátano-sandía, durazno, papaya y cacahuate, cada uno.

Conclusiones: el síndrome de alergia oral afecta más a mujeres que a hombres, las comorbilidades alérgicas más frecuentes en pacientes con síndrome de alergia oral son rinitis alérgica y asma, por tanto, en los pacientes con asma y rinitis alérgica sensibilizados a polénes debemos interrogar con respecto a los síntomas sugerentes de síndrome de alergia oral.

Keywords: Associated foods; Diagnosis; Oral allergy syndrome; Pollen-food syndrome; Prevalence; Prick-by-prick test; Treatment.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Food Hypersensitivity* / epidemiology
  • Food Hypersensitivity* / immunology
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Skin Tests
  • Syndrome
  • Tertiary Care Centers
  • Young Adult