Pollen food allergy syndrome (PFAS): A review of current available literature

Ann Allergy Asthma Immunol. 2019 Oct;123(4):359-365. doi: 10.1016/j.anai.2019.07.022. Epub 2019 Jul 31.


Objective: Pollen food allergy syndrome (PFAS) is a complex syndrome posing a diagnostic and therapeutic challenge. Our objective was to summarize the available literature regarding its prevalence, pathogenesis, diagnosis, and treatment.

Data sources: A PubMed search was performed to include English language articles with the following search terms: pollen food syndrome, pollen food allergy syndrome, PFAS, oral allergy syndrome, OAS, food anaphylaxis, food components.

Study selections: Human articles discussing PFAS.

Results: Varying reports have been made of the prevalence of PFAS, ranging from 4.7% to greater than 20% in children and 13% to 58% in adults. Prevalence varies widely by geographic region. PFAS is typically the results of class II food allergens (e.g. sensitized to anaeroallergen, but reaction occurs due to cross reactivity from a food allergen). Commonly these reactions are limited to the oropharynx due to the lability of the proteins causing the reaction. As multiple families of proteins with varying stability cause PFAS, severe systemic reactions are also possible, as anaphylactic shock has been documented in up to 1.7% of reactions.

Conclusion: Pollen food allergy syndrome therefore cannot be dismissed as a benign food allergy, but it needs to be approached individually based on known risk factors.

Publication types

  • Review

MeSH terms

  • Adult
  • Allergens / classification
  • Allergens / immunology*
  • Child
  • Cross Reactions
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / immunology*
  • Food Hypersensitivity / pathology
  • Humans
  • Pollen / immunology*
  • Rhinitis, Allergic, Seasonal / immunology*


  • Allergens