Clinical cross-reactivity among foods of the Rosaceae family

been increasingly reported as causes of allergic reaction. Patients frequen tly have positive skin tests or radioallergosorbent test results for multip le members of this botanical family. Objective: Our purpose was to investigate the clinical crossreactivity asse ssed by double-blind, placebo-controlled food challenge (DBPCFC) of Rosacea e foods (apricot, almond, plum, strawberry, apple, peach, and pear). Methods: Thirty-four consecutive adult patients complaining of adverse reac tions to Rosaceae were included in the study. Skin prick tests and CAP Syst em (FEIA) were performed with Rosaceae foods in all patients. Clinical reac tivity to Rosaceae was systematically evaluated by open food challenges (OF Cs), unless there was a convincing history of a recent severe anaphylaxis, Positive reactions an OFCs were subsequently evaluated by DBPCFCs, Results: Twenty-six and 24 patients had positive skin prick tests and CAP F EIA with Rosaceae, respectively; from these 88% and 100% had positive tests with greater than or equal to 2. No evidence of clinical reactivity was fo und in 66% percent of positive skin prick tests and 63% of positive specifi c IgE determinations to fruits. A total of 226 food challenges (including O FC and DBPCFC) were performed in the 28 patients with positive skin prick t ests or CAP System FEIA. Of 182 initial OFCs carried out, 26 (14%) reaction s were confirmed by DBPCFCs, Overall, 40 reactions were considered positive in 22 patients with positive skin tests or CAP FEIA, Thirty-eight reaction s had been previously reported, the remaining two were detected by systemat ic challenges. Most reactions were caused by peach (22 patients), apple (6) , and apricot (5), Ten patients (46%) were clinically allergic to peach and other Rosaceae, Conclusion: Positive skin test and CAP System FEIA should not be taken as t he only guide for multi-species dietary restrictions. Nevertheless, the pot ential clinical allergy to other Rosaceae should not be neglected. If the r eported reaction is confirmed, current tolerance to other Rosaceae should b e precisely established unless there has been ingestion without symptoms af ter the reaction.