[Pollinosis and oral allergy syndrome]

Allergic diseases are frequent, affecting 10%-15% of the population. The atopic symptoms manifest mainly as pollinosis or bronchial asthma. Many of the atopic patients have an additional food-related allergy, often due to a cross-reactivity between pollen allergens (birch, hazelnut, alder, mugwort) and food allergens. The foods which most frequently elicit oral, gastro-intestinal or anaphylactic symptoms are fruits such as apples, peaches, cherries or apricots, but also nuts and vegetables from the botanic group of the compositae (celery, carrots, fennel, sunflower kernels, camomile, parsley, etc.). While fruits mainly cause oral symptoms (aphthae, stomatitis, swelling of the lips or tongue, pharyngitis, hoarseness and laryngeal oedema), nuts and celery can often also induce acute generalized symptoms, such as severe laryngeal oedema, bronchial asthma, urticaria or allergic shock. In our experience these patients tend to minimize their oral symptoms and the practitioner has often to ask about them specifically.