A citrus allergy is an immune system reaction where the body mistakenly identifies proteins in citrus fruits as harmful. This can lead to symptoms ranging from mild discomfort to severe, life-threatening reactions. This article explores citrus allergy commonality and general information.
Prevalence of Citrus Allergy
Citrus allergies are uncommon compared to more prevalent food allergies like those to nuts or shellfish. Documented cases confirm these allergies occur, often linked to Oral Allergy Syndrome (OAS) due to cross-reactivity with pollen allergies.
This cross-reactivity occurs because certain proteins found in citrus fruits resemble those in pollens, particularly grass pollens. A 2013 study found that 39% of individuals with grass pollen allergies showed sensitivity to citrus fruits like oranges, lemons, and clementines in prick tests. This suggests that while a true primary citrus allergy is rare, reactions can be more common in those with existing pollen sensitivities.
Recognizing Symptoms
Symptoms of a citrus allergy vary widely and can affect different body systems. Oral reactions are common, including tingling, itching, redness, and mild swelling of the lips, tongue, and throat after consumption.
Skin reactions are also common, presenting as hives, redness, burning, itching, dry skin, or blisters. These can result from consuming citrus or direct contact with peels, causing contact dermatitis. Digestive symptoms include nausea, vomiting, abdominal pain, cramps, and diarrhea.
Less common respiratory symptoms include wheezing, coughing, nasal congestion, and difficulty breathing. In severe cases, a citrus allergy can trigger anaphylaxis, a medical emergency. Anaphylaxis symptoms include widespread hives, flushed skin, significant swelling of the mouth and throat, asthma, low blood pressure, and gastrointestinal distress, requiring immediate medical attention.
Allergy Versus Intolerance
It is important to distinguish between a citrus allergy and a citrus intolerance, as they involve different bodily responses. A citrus allergy is an immune-mediated reaction where the body’s immune system produces antibodies, specifically IgE antibodies, against proteins in citrus fruits. This immune response triggers the release of chemicals like histamine, leading to allergic symptoms.
In contrast, citrus intolerance is a non-immune reaction, typically affecting the digestive system. Symptoms often include bloating, diarrhea, gas, heartburn, or acid reflux, and are less severe than allergic reactions. An allergy carries the risk of severe, systemic reactions like anaphylaxis, which intolerance does not.
Diagnosis and Management
Diagnosing a citrus allergy involves consulting an allergist. Diagnostic methods include reviewing medical history, skin prick tests, or blood tests. A skin prick test applies a small amount of citrus extract to the skin to observe for a localized reaction. Blood tests measure the level of specific IgE antibodies in the bloodstream that react to citrus proteins. An oral food challenge, conducted under medical supervision, may be used to confirm a diagnosis.
Managing a citrus allergy primarily involves strict avoidance of citrus fruits and products. This requires careful reading of food labels, as citrus components can be present in many processed foods and beverages. For accidental exposures, antihistamines can alleviate mild symptoms. Individuals at risk of severe reactions, including anaphylaxis, are prescribed an epinephrine auto-injector and should carry it at all times.