Oral allergy syndrome in a child provoked by royal jelly

Area of Science:

• Allergy and Immunology
• Food Science
• Pediatrics

Background:

• Royal jelly exhibits diverse physiological activities, but reported reactions vary.
• Oral Allergy Syndrome (OAS) is a common allergic reaction to foods.
• Investigating adverse reactions to royal jelly is crucial for patient safety.

Purpose of the Study:

• To describe a case of oral allergy syndrome (OAS) in a child after royal jelly ingestion.
• To identify the specific allergens responsible for the royal jelly-induced reaction.
• To explore potential causes, including contamination and cross-reactivity.

Main Methods:

• Skin prick tests (standard and prick-to-prick with royal jelly).
• Royal jelly patch testing.
• Specific IgE testing (ImmunoCAP) for various allergens, including Hymenoptera venom, inhalant allergens, food allergens, and lipid transfer proteins.

Main Results:

• Positive reactions to royal jelly via prick-to-prick and patch tests confirmed immediate hypersensitivity.
• Positive in vivo and in vitro tests for almond suggested potential royal jelly contamination.
• Elevated specific IgE to Compositae pollens indicated possible cross-reactivity.

Conclusions:

• The child was diagnosed with royal jelly immediate hypersensitivity.
• Almond pollen contamination or cross-reactivity with Compositae pollens are potential explanations for the allergy.
• Further investigation into royal jelly composition and allergenicity is warranted.