Seasonal Allergies, How They Relate to Oral Allergy Syndrome (OAS) ?
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Nicolle Cascone, RN, Tara Shankar, MD, Andrej A. Petrov, MD, Merritt L. Fajt, MD
Rationale: Patients with seasonal allergies are more likely to have oral allergy syndrome (OAS) resulting from cross-reactivity between protein in pollens and those in some fruits and nuts.  

Methods: We conducted a retrospective chart review of 222 adult patients seen in an Adult University Allergy clinic from  June 15, 2004 through June 15, 2014 with self-reported  food allergies.

Results: In 222 patients seen for food allergies, 81% (179) had environmental allergies. Fruit allergy was reported in 37% (n=82 patients), tree nut allergy in 36% (n=79), and peanut in 25% (n=55). Patients with seasonal allergies had an increased frequency of reported fruit allergy and tended to have an increased frequency of tree nut allergy  vs. patients without seasonal allergies (41% vs. 21%, p=0.015 and 39% vs. 23%, p=0.06, respectively) but no difference in peanut allergy frequency (p=0.36).    In the 179 seasonal allergy patients, OAS symptoms were reported in 45% (n=80).  In these OAS patients,  74% reported fruit allergy, 45% tree nut allergy and 20% peanut allergy.   In these 80 OAS patients,55% (n=44) underwent skin prick or serum specific IgE testing for the fruit and/or nut with positive results in 66% (n=29) of these patients. 

Conclusions: This data suggests that in patients with seasonal allergies, fruit and nut allergy is more common than in those without seasonal allergies. In those with oral symptoms who underwent testing, the majority (66%) had evidence of an IgE mediated sensitivity. It remains to be determined if these patients have isolated OAS or are at risk for anaphylaxis.