IGE-MEDIATED FOOD ALLERGIES INCLUDING ORAL ALLERGY SYNDROME IN 383 PATIENTS

383 predominantly adult patients (66.4% females, 33.6% males) with pro ved IgE-mediated food allergies (FA), including the oral allergy syndr ome (OAS), were seen at the Allergy Unit of the Department of Dermatol ogy in Zurich during the years 1990 - 1994. 63.2% of them had addition al manifestations, predominantly a pollen allergy (60.3%). The FA mani fested earlier in males (36.4% before 20 years old) than in females (1 7.7%). The organ manifestation of symptoms of FA was most often the sk in (60%) with urticaria and angioedema and the oro-gastrointestinal tr act (60%), if the OAS was included. 40% had respiratory symptoms (rhin itis, asthma) and 7.6% symptoms of the cardiovascular system (anaphyla ctic shock). Usually, the patients showed involvement of two or more o rgans. 44.4% had exclusively skin symptoms, 28.7% isolated OAS and 9.1 % isolated gastrointestinal manifestations. Only 6.3% had chronic symp toms of a FA, the most common symptomatology was acute (30.5%) or recu rrent (63.2%). Hazelnut (36.8%), celery (celery tuber or celeriac) (36 .3%), apple (25.6%) and carrot (24.8%) were found to be the most frequ ent food allergens: hazelnut and apple elicited mostly an GAS, whereas celery caused generalized symptoms such as acute urticaria, asthma or anaphylactic shock. These food allergens belong to the so-called poll en-associated food allergens with sensitization mainly to birch. but a lso to mugwort pollens. Among the food non cross-reacting with pollens , an allergy was seen to peanut (12.8%), soja (9.1%), milk(10.7%), fis h (9.7%), hen's egg (5.7%) and beef meat (2.9%). These observations co nfirm again that in adults the type I allergic reactions to plant-deri ved food is commonly by a consequence of primary aero-sensitization to pollen allergens. A primary ingestive sensitization in non-atopic peo ple is rare in adults.