is an immunoglobulin E-mediated immediate allergic reaction caused by cross-reactivity between pollen and the antigens of foods - such as fruits, vegetables, or nuts - in patients with pollen allergy
is a common adverse reaction occurring few minutes after the consumption of vegetable foods in patients with pollen-induced seasonal allergic rhinoconjunctivitis (SAR) (2)
in Northern European countries
many patients with birch tree pollen sensitization develop PFAS that is induced by plant food, such as tree nuts and fruits, particularly those of the Rosaceae family
in Southern European countries
PFAS is mainly represented in patients polysensitized to various pollens
in Japan
sensitization to Japanese cedar is the main trigger of airborne allergy, and it's associated with PFAS due to fresh tomato in some cases
in Australian children
watermelon is the most common triggering food among children with grass pollen and birch allergy
pathogenesis of PFAS
is linked to a respiratory allergy to pollens and subsequent cross-reactivity between pollens and homologous epitopes contained in plant-derived food proteins (class 2 food allergy) (2)
is a type I cross-reaction mediated by IgE antibodies between an aeroallergen and a plant-derived antigen (3)
is often called oral allergy syndrome because symptoms appear mainly in the lips, mouth, and pharynx
clinically characterized most frequently by isolated oral and pharyngeal symptoms at immediate onset following food intake, which is called oral allergy syndrome (OAS) (2)
symptoms typically consist of localized oral symptoms such as numbness of the lip or mouth, itching, tingling and swelling of lips, tongue, palate and pharynx without systemic symptoms (3)
PFAS however is a more appropriate term because the symptoms appear around the mouth as well as in the gastrointestinal tract and respiratory organs (1)
symptoms of PFAS are generally restricted to the oropharyngeal mucosa and occur immediately, or in 5-10 min after consuming fresh fruits, vegetables, nuts, legumes and seeds (2)
oropharyngeal symptoms comprise:
labial and oropharyngeal pruritus,
paresthesia,
angioedema of the oral mucosa, lips, tongue, palate and pharynx,
itchy ears,
mucosal red patches and blisters and sensation of laryngeal tightness that may cause hoarseness (OAS)
symptoms typically last for a few minutes to half an hour
systemic reactions have been reported in 2-10% of cases
pollen sensitization is uncommon in young children, and PFAS occurs more frequently in older children, adolescents, and adults (1)
Mastrorilli C, Cardinale F, Giannetti A, Caffarelli C. Pollen-Food Allergy Syndrome: A not so Rare Disease in Childhood. Medicina (Kaunas). 2019 Sep 26;55(10):641. doi: 10.3390/medicina55100641. PMID: 31561411; PMCID: PMC6843262.
Kar Kurt O et al [Pollen food allergy syndrome]. Tuberkuloz ve Toraks. 2017 Jun;65(2):138-145. DOI: 10.5578/tt.32167. PMID: 28990893.
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.