The Clinical Spectrum of Reactions Due to Banana Allergy

Öz 60 Abdullah Dayıoğlu1, Sena Akgiray1, Hikmet Tekin Nacaroğlu1, Semiha Bahçeci Erdem2 1İstanbul Medipol University Faculty of Medicine, Department of Pediatric Allergy and Immunology, İstanbul, Turkey 2Çiğli Regional Training and Research Hospital, Clinic of Pediatric Allergy and Immunology, İzmir, Turkey CASE REPORT Address for Correspondence: Hikmet Tekin Nacaroğlu, İstanbul Medipol University Faculty of Medicine, Department of Pediatric Allergy and Immunology, İstanbul, Turkey E-mail: tekin212@gmail.com ORCID ID: orcid.org/0000-0003-1333-2648 Received: 24.04.2020 Accepted: 12.05.2020 Cite this article as: Dayıoğlu A, Akgiray S, Nacaroğlu HT, Erdem SB. The Clinical Spectrum of Reactions Due to Banana Allergy. Bagcilar Med Bull 2020;5(2):60-63 ©Copyright 2020 by the Health Sciences University Turkey, Bagcilar Training and Research Hospital Bagcilar Medical Bulletin published by Galenos Publishing House. Introduction Food allergy is defined as an abnormal or exaggerated immune response to food proteins. It has been reported that 4-6% of the world’s child population has food allergy (1). Responsible foods differ according to culture and population. While the most common food causing allergies in the United States pediatric population are cow’s milk, eggs, peanuts, soy, wheat, fish and shellfish, peanuts, fish and shellfish are more common in adults (1). In a study conducted in the Black Sea region of Turkey, beef (31.8%), cow’s milk (18.1%), cocoa (18.1%), eggs (13.6%), and kiwi (13.6%) were found to be among the most common food allergens (2). In another study conducted in Turkey, eggs (57.8%), cow’s milk (55.9%), nuts (21.9%), peanuts (11.7%), walnuts (7.6%), lentils (7.0%), wheat (5.7%) and cattle meat (5.7%) were found as other allergens (3). Allergic reactions to bananas have rarely been reported. It has been shown in studies from different parts of the world that banana allergy is seen between 0.04% and 1.2% in the general population (4). Five allergens causing banana allergy have been identified. Mus a 1 profile, actin binding protein, weighing 14 kilodaltons, found in all eukaryotic cells; causes cross reaction with pollen and plants. Mus a 2 is a member of class 1 chitinase pathogen-associated Bagcilar Med Bull 2020;5(2):60-63 DO I: 10.4274/BMB.galenos.2020.04.013 Dayıoğlu et al. The Clinical Spectrum of Reactions Due to Banana Allergy Bagcilar Medical Bulletin, Volume 5, Issue 2, June 2020 protein family 3. It causes skin test positivity in more than 50% of cases with banana allergy. In addition, plant-derived nutrient class 1 chitinase is the most important panallergen causing Latex-fruit syndrome. Mus a 3 (non-specific lipid transfer protein), Mus a 4 (thaumatin like protein) and Mus a 5 (β-1.3 glucanase) have been reported by the IUIS Allergen Nomenclature Sub committee in recent years (5,6). The clinic reports mostly moderate local allergic reactions (Oral Allergy syndrome) to banana, though some reports state reactions reaching anaphylaxis (7). In this report, three cases with banana allergy with different clinical findings are presented.