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A Rare Case of Systemic Reaction to Carrot Due to PR-10 in a Young Child

C Ferrigno1, C P Ratti2, I Scavone1

  • 1Allergy Unit-Department of Pediatrics, Buzzi Children's Hospital, Milan, Italy.

Pediatric Allergy, Immunology, and Pulmonology
|June 23, 2025
PubMed

Insights

Pollen-Food Allergy Syndrome (PFAS) can rarely cause severe systemic reactions, not just mild oral symptoms. High IgE levels to Bet v 1 during pollen season may increase this risk.

Area of Science:

  • Allergy and Immunology
  • Clinical Medicine
  • Molecular Diagnostics

Background:

  • Pollen-Food Allergy Syndrome (PFAS) commonly causes mild oral symptoms.
  • Pathogenesis-related proteins group 10 (PR-10) are linked to oral allergy syndrome due to their sensitivity to heat and digestion.
  • Systemic reactions in PFAS are rare but possible.

Purpose of the Study:

  • To report a case of anaphylaxis due to raw carrot consumption in a patient with birch pollen allergy.
  • To highlight potential risk factors for systemic reactions in PFAS.
  • To emphasize the importance of recognizing systemic PFAS manifestations.

Main Methods:

  • Case report of a 12-year-old boy with birch pollen allergy.
  • Clinical history of reactions to raw carrot and fennel.
  • Molecular diagnostics for specific IgE to PR-10 allergens.
  • Assessment of reaction during pollen season and tolerance to cooked carrot.

Main Results:

  • The patient experienced anaphylaxis after consuming raw carrot.
  • Molecular diagnostics confirmed isolated PR-10 sensitization (Bet v 1).
  • The reaction occurred during birch pollen season, and cooked carrot was tolerated.

Conclusions:

  • PFAS can present with severe systemic reactions, not exclusively mild oral symptoms.
  • High specific IgE for Bet v 1 and concurrent pollen season may be risk factors for systemic PFAS.
  • Clinicians should consider the potential for systemic reactions in pollen-cross-reactive allergies.

Keywords:
PR-10anaphylaxiscarrotpediatricpollen-food allergy syndrome

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