A peach allergy is an immune system reaction to specific proteins in the fruit, which the body mistakenly identifies as harmful after consuming or handling them. It is a frequently reported fruit allergy that can develop at any point in a person’s life, even if they have previously eaten the fruit without issue.
Peach Allergy Symptoms
Reactions to peaches range from mild and localized to severe and systemic. One of the most common presentations is Oral Allergy Syndrome (OAS), also known as Pollen Food Allergy Syndrome (PFAS). This occurs within minutes of eating raw peaches and includes symptoms like itching or tingling in the mouth, throat, and lips. The swelling of the lips, tongue, and face may also occur.
Beyond the mouth, symptoms can affect the skin and gastrointestinal system. Cutaneous reactions include hives, an itchy rash, or the worsening of eczema. Digestive issues such as abdominal pain, cramping, nausea, vomiting, or diarrhea can occur after ingesting peaches. These symptoms can appear anywhere from a few minutes to a couple of hours after consumption.
In the most serious cases, a peach allergy can induce anaphylaxis, a life-threatening reaction that affects multiple body systems. Signs of anaphylaxis require immediate medical attention and can include difficulty breathing, wheezing, and a repetitive cough. A sudden drop in blood pressure can lead to shock and a loss of consciousness.
Causes and Cross-Reactivity
The cause of a peach allergy is an immune response where Immunoglobulin E (IgE) antibodies recognize specific proteins in the fruit as a threat. One of the primary proteins responsible for more severe, systemic reactions is the Lipid Transfer Protein (LTP). These LTPs are concentrated in the peach’s skin and are heat-stable, meaning that cooking or processing the fruit may not prevent an allergic reaction.
This immune response often extends beyond peaches due to cross-reactivity. The immune system may mistake proteins in other substances for the peach proteins, triggering a similar allergic reaction. This is common with other fruits from the Rosaceae family, including apples, plums, cherries, apricots, and pears. A person with a peach allergy might also react to certain nuts, like almonds and hazelnuts, or vegetables like celery and carrots.
Cross-reactivity is also the link between peach allergy and pollen allergies. Many people who are allergic to birch or mugwort pollen experience Oral Allergy Syndrome when they eat peaches. Their immune system confuses the proteins in the peach with the structurally similar proteins in the pollen they are sensitized to. This connection explains why some individuals only experience mild, localized symptoms.
Diagnosis and Management
If a peach allergy is suspected, an allergist can perform tests to confirm the diagnosis. A common method is a skin-prick test, where a small amount of peach extract is applied to the skin, which is then lightly pricked; a raised, red bump indicates a likely allergy. Another diagnostic tool is a specific IgE blood test, which measures the level of these antibodies in the bloodstream. In some cases, an oral food challenge, conducted under strict medical supervision, may be used.
The primary management strategy for a peach allergy is the strict avoidance of peaches. This requires careful reading of food labels on products like juices, jams, desserts, and even some cosmetics. Individuals must also be cautious when dining out, as peaches can be a hidden ingredient. Awareness of cross-reactive foods is also important, as avoiding them may be necessary.
For accidental exposure, treatment depends on the severity of the reaction. Mild symptoms, such as those associated with OAS, can often be managed with over-the-counter antihistamines. For individuals at risk of anaphylaxis, carrying an epinephrine auto-injector is necessary. An emergency action plan should outline when and how to use the epinephrine and to seek immediate medical help.