[A clinical study of two cases with immediate hypersensitivity to apple-pulp and an investigation of cross-allergenicity between apple-pulp allergen and some other pollen allergens].
In Japan there are no case reports of immediate hypersensitivity to apple-pulp. Here, we report on two patients: a 23-year-old woman and a 14-year-old girl with 3-year and 7-year histories, respectively, of anaphylactic reactions to apple-pulp. In the first patient, eating raw apples immediately elicited itching and tingling of the lips and mouth with severe edema of the lips and tongue, irritation of the throat and slight colic in the upper abdomen. In the second, nausea and vomiting occurred after ingestion of apples. In skin prick tests, they showed positive reactions to apple-pulp extract prepared by the method of Björkstén et al. and to fresh apple juice. In addition, IgE antibody to the apple-pulp extract was detected in the sera of both patients. They also possessed IgE antibodies to some other species of both pollens and fruits/vegetables in their sera. In the present study, cross-allergenicity between apple-pulp and five pollen species, which consisted of birch, Japanese cedar, orchard grass, mugwort and ragweed pollen, was investigated by RAST inhibition. The apple-pulp extract effectively inhibited RASTs to all the pollens except Japanese cedar pollen. These results suggested that the four pollens might have shared allergen with the apple-pulp extract.