Nectarines, a popular stone fruit, can trigger allergic reactions when the immune system mistakenly identifies a harmless protein in the fruit as a threat. While not as frequently reported as some other food allergies, a reaction to nectarines can occur.
Recognizing Symptoms
Mild to moderate symptoms often involve the mouth and throat, including itching or tingling sensations in the lips, mouth, or throat, known as Oral Allergy Syndrome (OAS). Skin reactions like hives or a rash, along with mild stomach discomfort, may also appear. OAS symptoms typically appear quickly after consuming raw nectarines and tend to resolve within minutes as the food is swallowed.
More serious reactions, though less common, can involve the entire body. These symptoms, known as anaphylaxis, require immediate medical attention. Signs include difficulty breathing, wheezing, or swelling of the throat or tongue. Other signs may involve dizziness, a rapid or weak pulse, or a sudden drop in blood pressure.
Understanding the Causes
A “true” nectarine allergy is often linked to the protein Pru p 3, a lipid transfer protein (LTP). Allergies to Pru p 3 are typically associated with more widespread, systemic reactions. This protein is heat-stable, meaning cooking the nectarine may not eliminate its allergenic properties.
Many nectarine allergies, however, are a result of cross-reactivity, often manifesting as Oral Allergy Syndrome (OAS). This occurs when the immune system, already sensitized to certain tree pollens like birch or alder, mistakenly identifies similar proteins in nectarines. Symptoms are generally localized to the mouth and throat because the allergenic proteins in nectarines that cause OAS are often heat-sensitive and break down in the digestive system, meaning cooked or processed nectarines, such as in jams or pies, might be tolerated.
Diagnosis and Living with a Nectarine Allergy
If a nectarine allergy is suspected, consulting an allergist is important for diagnosis. The diagnostic process often begins with a thorough review of medical history and symptoms. Diagnostic methods may include skin prick tests or blood tests that measure specific IgE antibodies to nectarine proteins.
In some cases, particularly when initial tests are inconclusive, a supervised oral food challenge may be conducted in a medical setting. This involves consuming increasing amounts of nectarine under close medical observation.
Managing a nectarine allergy involves avoiding the fruit and any products containing it. Careful reading of food labels is essential to identify hidden ingredients.
Individuals with a nectarine allergy, especially those with OAS, may also react to other botanically related foods due to cross-reactivity. These can include other stone fruits like peaches, plums, cherries, and apricots, as well as apples, pears, almonds, carrots, celery, and hazelnuts. An allergist can offer personalized dietary recommendations based on individual sensitivities.
For individuals with a history of severe reactions, carrying an epinephrine auto-injector is crucial. This device delivers epinephrine, the primary treatment for anaphylaxis. Carry two doses and ensure family, friends, and caregivers are trained on how and when to use it. After administering epinephrine, immediate medical attention is necessary, even if symptoms improve.