Natural Tolerance Development to Peach in a Child with Lipid Transfer Protein Allergy

Non-specific lipid transfer proteins (LTPs), present in multiple plant foods and pollens, are the predominant allergen in peach allergy in the Mediterranean region and may induce life-threatening allergic reactions. Although reasonably studied in adults, LTP allergy has been rarely described in children, and to the best of the author's knowledge, natural tolerance development during childhood to this allergen has not been reported to date. The authors reported the case of a 21 month-old boy who presented urticaria and facial edema 15 minutes after eating a peach. Sensitization to peach LTP was confirmed by skin prick tests and specific IgE. At the age of 32 months, skin prick tests and specific IgE to peach LTP were negative, so a food challenge was performed. The child tolerated one medium-sized peach. Peach and peach-related fruits were reintroduced in the child's diet. The authors discuss the relevance of regular allergy workup and dietary recommendations in children with LTP allergy.