Unusual Allergies – Poultry

This was previously posted to my old blog, Itch, Swell, Ooze, Wheeze in January 2016. This is an updated version for 2020.

Allergic reactions to the consumption of poultry are surprisingly well documented and have been known to cause anaphylaxis, contact and airborne reactions, allergy to poultry is thought to affect 0.6%–5% of the population.  

There is anecdotal evidence of poultry causing eyes to swell closed from handling raw and cooked poultry.  Airborne reactions to allergens is always of concern for people who have allergic asthma or respond to certain allergens with breathing problems, this would definitely be something to make a note of when discussing your symptoms with your medical provider.

Diagnosis and Management

Diagnosis for poultry allergy can be diagnosed through skin prick tests and IgE blood tests. As with most allergies, symptoms can be managed by avoidance of the offending food and its by-products.

Other Linked Allergies

In chicken-allergic patients there have been reports of cross reactions from parrot, budgerigar, chicken, pigeon, goose and duck.

Other members of this group of birds include wildfowl such as pheasants and partridges and commonly eaten birds such as quail and turkey.  Chicken and turkey meat are cross-reactive and responsible for most allergic reactions while duck and goose meat cause milder or no symptoms.

There is also a link between poultry allergies and alpha gal allergies (allergies to red meat).

Protein Changes

The main protein thought to be responsible is Chicken serum albumin (which is identical to alpha livetin found in egg yolk).

This is a partially heat-labile allergen (partially damaged by heat); Small studies have shown that IgE reactivity to Chicken albumin was reduced by 88% after heating at 90 degrees Celsius for 30 minutes.

There is some anecdotal evidence that people may be unable to eat cooked fresh chicken without having allergic symptoms but are able to eat chicken which has been fully frozen before being thawed, cooked, and eaten. This can be explained by a protein shape change caused by freezing or by cooking for an extended period, essentially damaging the protein so it cannot cause a reaction.

The alpha livetin protein is partially heat labile, so some sufferers will only get reactions from raw chicken and others may get reactions depending on how high a temperature the meat was cooked at and how long for.

Are chicken and egg allergy linked?

This is not an entirely crazy question as one comes from the other. This is sometimes called Bird-Egg Syndrome.

Bird-Egg Syndrome is well studied; it is described as a patient with a poultry allergy who becomes sensitised to birds’ eggs.

This new sensitivity to egg is to the proteins in egg yolk, alpha livetin (gal d 5), which is found in both chickens and eggs.

Commonly, IgE allergy to egg is usually from the egg white (proteins gal d 1 to 4), so whilst people who are allergic to chickens can become intolerant or allergic to egg, it doesn’t usually work the other way around due to the different proteins involved.

Allergy to feathers?

Inhalable feather dust contains several allergenic components, which cross-react with serum allergens and with similar bird species.

Allergy to bird feathers is not as common as you might think in commercial products. After intense production, washing and drying at high temperatures most of the allergenic proteins are removed from the feathers.

Unprocessed feathers and prolonged exposure to living birds may cause a patient to come into contact with bird serum proteins (which can cause problems in those allergic to ingesting poultry), bird faeces and feather mites.

Studies have shown that people with egg allergies are unlikely to be allergic to feathers due to the different proteins involved. 

Jemma


Disclaimer

This is a blog and should not be used for advice on diagnosis or treatments. 

If you think you may have a food allergy please contact your GP in the first instance to discuss treatment options.


References and Further Reading

Websites

http://acaai.org/allergies/types/food-allergies/types-food-allergy/meat-allergy

http://www.phadia.com/en/Products/Allergy-testing-products/ImmunoCAP-Allergen-Information/Epidermals-and-Animal-Proteins/Allergens/Chicken-serum-proteins/

http://www.phadia.com/Products/Allergy-testing-products/ImmunoCAP-Allergen-Information/Epidermals-and-Animal-Proteins/Allergens/Chicken-feathers/

http://www.allergen.org/search.php?TaxOrder=Galliformes

Research Papers

Gal d 7—a major allergen in primary chicken meat allergy, 2020

Actin as a Possible Cross-Reactive Allergen Between Fish and Poultry, 2019

Meat allergy and allergens, 2018

Molecular and Extract-Based Diagnostics in Meat Allergy, 2017

Update on the bird-egg syndrome and genuine poultry meat allergy, 2016

Chicken Meat Anaphylaxis in a Child with No Allergies to Eggs or Feathers, 2014

Severe Allergy to Chicken Meat, 2006

Bird-egg Syndrome in Children, 2003

Chicken Serum Albumin (Gal D 5*) Is a Partially Heat-Labile Inhalant and Food Allergen Implicated in the Bird-Egg Syndrome, 2001

Identification of Alpha Livetin as a Cross Reacting Allergen in a Bird-Egg Syndrome, 1994

Egg Protein Sensitization in Patients With Bird Feather Allergy, 1991

June – Articles of Interest

Yet another month in lockdown here in the UK, the children won’t go back to school until September at the earliest and we continue to work from home.

Lots of interesting stuff this month including a Covid-19/allergy study in children which was reassuring.

Molecular approach to a patient’s tailored diagnosis of the oral allergy syndrome

The Sensitivity to Food Allergies in Individuals with Asthma

Phenotyping peach‐allergic patients sensitised to LTP and analysing severity biomarkers. LTP means Lipid Transfer Protein and are found in fruit, vegetables and cereals – you can read more about them on an informative page at Anaphylaxis Campaign here.

Eczema herpeticum emerging during atopic dermatitis in infancy

May rotavirus vaccine be affect food allergy prevalence? Spoiler alert for those that don’t click on the links – it was found that there was no significant increase in food allergy following vaccination.

Dietary factors during pregnancy and atopic outcomes in childhood: a systematic review from the European Academy of Allergy and Clinical Immunology

Foods Causing Highest IgG Immune Response in Saudi Arabia

Clinical characteristics of 182 pediatric COVID‐19 patients with different severities and allergic status. There was no difference between allergic and non‐allergic COVID‐19 children in disease incidence, clinical features, laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS‐CoV‐2 infection and hardly influenced the disease course of COVID‐19 in children.

Late introduction of solids into infants’ diets may increase the risk of food allergy development

Insights into pediatric pollen food allergy syndrome. Also known as Oral Allergy Syndrome

Food allergy test in chronic urticaria adult patients: A cross sectional study

If you spot an article or research that you think would interest me you can message my Facebook page or tag me in a Tweet.

Jemma


Disclaimer

This is a blog and should not be used for advice on diagnosis or treatments.  If you think you may have a food allergy please contact your GP in the first instance to discuss treatment options.


Unusual Allergies – Honey

This was previously posted to my old blog, Itch, Swell, Ooze, Wheeze in August 2015. This is an updated version for 2020.

We went to Devon a few years ago on holiday and had the pleasure of visiting Quince Honey Farm, which I am pleased to say in 2020 is still going strong.

It is a strange combination of honey museum, live beehive exhibits (which were my favourite) and a soft play centre for the children, which was the main reason we paid a visit.

Quince Honey Farm

I have a friend who is allergic to honey (and bee venom) and a work colleague keeps bees, so this type of allergy really piqued my interest.

Allergy to honey is relatively uncommon, but has been known to cause anaphylaxis.  It is thought that the cause of the allergic reaction is either from remnants of the bee in the honey or from minute traces of pollen.

As honey is not a top 14 allergen it may be harder to cater for those suffering from this allergy as it is added to processed food in various forms in things that you would not expect.

Look out for labels…

For those suffering with severe symptoms look for labels on baked goods, salad dressings, barbecue sauces, cereals, granola bars, smoothies, beers, and cocktails.  They will not be labelled as an allergen on UK packaging, so make sure you check very carefully if you or your child suffers from a honey allergy.

Honey is also used as an ingredient in many cosmetics, including lip balms, moisturisers, and hair products, so if you suffer from severe reactions it is important to check ingredients on everything you use.

Linked Allergies

Honey is primarily sugar; proteins which may cause allergy have not yet been identified (if there are any).

The linked allergies are from what else may be within the honey, trace contaminants of:

  • Pollen particles
  • Antibiotics and herbicides
  • Bee and hive remnants

Honey remains a rare allergy, despite the number of people suffering from pollen allergies, as most people are allergic to the pollen of trees and grass than they are to plant pollens.

However there have been studies showing honey which contained pollen from the plant family Compositae (which includes sunflower and ragweed) is more likely to cause allergic symptoms.

Honey varieties

Honey can be mono-floral (honey made from a single type of plant) or multi-floral (honey from lots of different types of plants). E.g. Orange Blossom Honey is made from bees visiting only Orange Blossom plants. Most shop bought honey in the UK is multi-floral.

Honey is often pasteurised, which is not to kill bacteria, as is done in the milk industry, but to kill yeasts which are present from the nectar. It also gives a better appearance to the final product, but is claimed to reduce many of the health benefits, such as vitamins and minerals which may be lost in the heating process.

Non-pasteurised honey is often referred to as Raw Honey (sometimes Artisan Honey in the US) and is roughly filtered to remove large hive components, bee parts and wax which may have inadvertently got into the honey, whilst still retaining all the health benefits. As this is not heat treated to remove trace contaminants it is more likely to cause reactions.

Honey and Venom Links

The link between bee sting allergy and honey allergy is weak. Bee venom is made of several components which work in conjunction with each other; these can be partially lost in the honey making process and would not have the same effect when ingested (I have linked to studies below where links have been made in a couple of cases).

Jemma


Disclaimer

This is a blog and should not be used for advice on diagnosis or treatments.  If you think you may have a food allergy please contact your GP in the first instance to discuss treatment options.


References and Further Reading

Websites

http://www.bbka.org.uk/learn/general_information/honey

Thermo Scientific – Honey Allergy

Research Papers

A rare case of multiple severe anaphylaxis caused by thyme, black pepper, wasp and honey, 2019

Ragweed components in honey, 2017

Anaphylaxis caused by honey: a case report, 2017

Contamination of honey by the herbicide asulam and its antibacterial active metabolite sulfanilamide, 2004

Whole bee for Diagnosis of Honey Allergy, 2002

Immunochemical screening for antimicrobial drug residues in commercial honey, 1998

Venom allergy, 1998

Honey allergy is rare in patients sensitive to pollens, 1995

Allergy to honey: relation to pollen and honey bee allergy, 1992

May – Articles of Interest

Another month has gone by in lockdown, the children are not back at school yet and we intend to continue as we have been until the end of June and then see how things are going in the UK.

Here is my quick round-up of published allergy and eczema articles this month and what I have found interesting.

Flagellate dermatitis caused by the intake of shiitake mushrooms. A case report and review of the literature

My first thought on this one was “what is flagellate dermatitis?”, it’s a linear rash that resembles whiplash marks and it is very closely associated with consumption of shiitake mushrooms.

Galactose-α-1,3-galactose (alpha-gal) allergy: first pediatric case in a series of patients in Spain

Alpha gal allergy is an allergy to proteins found in meat.

Allergic hypersensitivity to garlic and onion in children and adults

This one is of personal interest to me as my brother and maternal aunt are both sensitive to garlic. 

Milk allergy most burdensome in multi‐food allergic children

Yes it is, in our family at least!  The study concluded that parents whose children have multiple food allergies, including milk, report milk as the allergy associated with the greatest time, financial , social and emotional burdens.

Likely questionnaire-diagnosed food allergy in 78, 890 adults from the northern Netherlands

I love these large scale studies, in this one they found  apple was the most prevalent reported allergenic food, followed by cow’s milk and hazelnut.  If you want to read more about apple allergies, I put some more resources together on this just last month.

Is it necessary to avoid all legumes in legume allergy?

Food allergy severity prediction: quite a way to go yet?

Stay safe everybody wherever you are!

If you spot an article or research that you think would interest me you can message my Facebook page or tag me in a Tweet.

Jemma

Apple Allergies

Apple allergies are more common than you think, in a 2014 EuroPrevall study apples were categorised as a Priority One Allergen (read more about EuroPrevall studies here).  Symptoms of apple allergy are most often non-anaphylactic with either Oral Allergy Syndrome symptoms or gastro-intestinal symptoms.

Diagnosis

Blood tests are generally unreliable in allergy diagnosis and as a less common allergy with less severe symptoms your doctor or hospital may be unwilling to perform an allergy test.  

As with most allergies it is recommended that elimination diets and avoidance are the safest, quickest and cheapest course of action.

If you think you may be allergic to apples and are interested in making a food diary to diagnose or manage your allergy, see my food diary download.

Look out for labels

Apple can be consumed as fresh, as a processed fruit and in juices and cider. Apple pectin is often used as a gelling agent in jams, jellies and relishes.  It may be hard to avoid when apple is used as a natural flavouring in products in things like sweets.

Key Allergens/Proteins in Apple Allergy

The most studied proteins in apple allergy are called Mal d 1, Mal d 2, Mal d 3 and Mal d 4.  87% of people suffering from this allergy are thought to be sensitised to the protein Mal d 1, but may be allergic to other combinations of proteins.

Linked Allergies

Apple-allergic patients may display cross-reactivity with pollen or food containing allergens with a similar protein structure to Mal d 1.

There have been found to be links with

Fruits and Vegetables

  • Cherry
  • Apricot
  • Pear
  • Celery
  • Carrot
  • Peach
  • Strawberry
  • Raspberry
  • Parsley
  • Asparagus
  • Bell Pepper
  • Potato
  • Melon
  • Mango

Nuts

  • Hazelnuts
  • Almonds
  • Peanuts

Pollen

  • Birch Tree Pollen

If you have two or more of these allergies there are links at the bottom of the page for Oral Allergy Syndrome.

Protein Changes

The amount of allergens in apples are influenced by the apple variety, the ripeness of the fruit and the storage conditions. Over-ripe and freshly harvested fruits have high levels of one protein, but longer storage increases the levels of other apple allergens.  

Mal d 1, the allergen most commonly causing allergic reactions is heat labile, which means the protein changes shape during cooking, which means it is no longer able to cause an allergic reaction (or in cases of extreme allergy, reduces the effects of any reaction).  Patients still having allergic reactions to apple after cooking are likely to be allergic to the allergen Mal d 3, which would be important to mention to an allergist if you are looking to be tested.

Apple Varieties

In recent studies (listed below) red‐fleshed apples displayed the lowest reactivity, followed by older and then newer varieties as newer varieties of apple are bred to be more crisp and tasty, increasing the amount of the offending proteins.  It was also noted that skin reactivity increased from the flesh of the apple to the peel and peel near the stalk.

Jemma


Disclaimer

This is a blog and should not be used for advice on diagnosis or treatments.  If you think you may have a food allergy please contact your GP in the first instance to discuss treatment options.


References and Further Reading

Journals

Apple Allergy—Development of Tolerance Through Regular Consumption of Low-Allergen Apples. An Observational Study, 2020

The Effect of Birch Pollen Immunotherapy on Apple and rMal d 1 Challenges in Adults with Apple Allergy, 2020

Allergen‐specific immunotherapy with apples: selected cultivars could be a promising tool for birch pollen allergy, 2020

Possibilities of Interlinking the Genomic Data and Allergenic Potential of Apples, 2019

Allergenicity of apple allergen Mal d 1 as effected by polyphenols and polyphenol oxidase due to enzymatic browning, 2019

Immunological characterization of recombinant Mal d 1, the main allergen from apple (Malus x domestica L. Borkh), 2019

The EuroPrevall outpatient clinic study on food allergy: Background and methodology, 2015

Websites

http://www.phadia.com/en/products/allergy-testing-products/immunocap-allergen-information/food-of-plant-origin/allergen-components/rmal-d-1-apple/

http://research.bmh.manchester.ac.uk/informall/allergenic-food/index.aspx?FoodId=2

https://www.allergyuk.org/assets/000/001/548/Oral_Allergy_Syndrome_original.pdf?1512985580

https://patient.info/allergies-blood-immune/food-allergy-and-intolerance/oral-allergy-syndrome

Unusual Allergies – Potato

This was previously posted to my old blog, Itch, Swell, Ooze, Wheeze in May 2014. This is an updated version for 2020.

Allergy to potato is relatively uncommon but the symptoms can be quite severe.  The main protein is patatin (or sol t 1) which is thought to be the allergen which causes the majority of allergic reactions.  There are several case studies available which show anaphylactic reactions to potato, especially in its raw form.  In older research from the sixties potato allergy was referred to as a “housewives allergy”, as the raw potato would cause an eczema reaction on the skin, cause allergic rhinitis or bring on asthma attacks from peeling potatoes.

Potato is not one of the EUs top 14 allergens, so is harder to cater for those suffering from this allergy as it is not only a common food source in Western countries, but it is also added to processed food in various forms in things that you wouldn’t expect.

Look at labels

For those suffering with severe symptoms look for labels which state potato starch, potato flour, dried or powdered potato and as an ingredient in alcohol (like vodka).  They will not be labelled as an allergen on packaging, so make sure you check very carefully if you suffer from a potato allergy.

Other Linked Allergies

Potato is part of the Nightshade family and has similar proteins in common with other members of this family such as tomatoes, aubergines (egg plant) and peppers.  With the severest form of the allergy a person may experience allergic responses to other vegetables in the Nightshade family.

Protein Changes

With some food proteins, like those found in egg, cooking can sometimes break down the proteins and cause either less of a reaction or none at all, these proteins are called heat labile. 

The main potato protein, patatin (sol t 1) is heat labile and may be less effective in causing an allergic reaction when cooked.  Unfortunately, other proteins found in potato (sol t 2, sol t 3 and sol t4) are thermostabile – which means they are not broken down by normal cooking temperatures, so may still cause allergic reactions in different forms.  

Roasting, boiling, baking and mashing potatoes may make no difference to some people suffering with a potato allergy and then for others a certain way of preparing the vegetable may ease symptoms.

Potato varieties

Different varieties of potato will have different levels of different proteins in, so depending on which protein you are reacting to there may be some types of potato that you would be able to tolerate, it may be a case of trial and error as to which you can eat.  Sweet potato is a very distant relative of the potato and is not a member of the Nightshade family, so should be OK to eat as an alternative in most cases as it does not contain the problem protein patatin.

Birch Pollen and Latex Links

Potato allergy has been linked to birch pollen allergy and latex due to similar protein shapes.  You may want to be careful with bandages and condoms as this is a common allergy which can cause swelling at the point of contact or in severe cases anaphylaxis.

Birch pollen in the United Kingdom is generally high between March and June.  Anti-histamines can reduce the symptoms of hayfever.

Jemma


Disclaimer

This is a blog and should not be used for advice on diagnosis or treatments.  If you think you may have a food allergy please contact your GP in the first instance to discuss treatment options.


References and Further Reading

Websites

http://www.phadia.com/en/products/allergy-testing-products/immunocap-allergen-information/food-of-plant-origin/vegetables/potato/

http://www.allergiesexplained.com/pages/Potato%20Allergy%20and%20Intolerance.htm

http://www.health24.com/Medical/Allergy/Allergy-triggers/Allergic-to-potatoes-20120721

http://www.worcester.ac.uk/discover/pollen-calendar.html

Research Papers

Cross-reactivity syndromes in food allergy, 2013

Allergy to vegetables belonging to the Solanaceae family, 2019

Anaphylaxis in an infant to raw potato, 2011

Aubergine and Potato Sensitivity with Latex Sensitisation and Oral Allergy Syndrome, 2013

Anaphylaxis to hidden potato allergens in a peach and egg allergic boy, 2017

Prevalence of sensitization and allergy to potato in a large population, 2017

Children with food allergies: How to build self-confidence

This is a guest post written by AllergyAbroad

Many children who suffer from food allergies go through their childhood and later, their teenage years, unable to be completely self-sufficient with their allergies. There are many reasons why this happens, but it stems from parents not knowing how best to teach ownership skills to their children. The good news is there are ways for parents to build confidence in their children so that they can manage their allergies without their parent’s supervision. 

Always try to prepare them from an early age. The following section shows four essential methods on how to build confidence in your children so they can be self-sufficient from an early age.

1-    Take ownership

Firstly, teach your child to take pride in who they are, and that includes their food allergy. There is no shame and embarrassment to be had, just emphasising the extra clarity needed when telling other people about their allergy. They will come across thousands of these conversations in their lifetime, but by giving them a headstart on this reframes how they see themselves from an early age. They are not the ones with a problem, they are now in position to educate other people when needed.

 2-    Honesty is the best policy

The second thing to remember is to always discuss this issue openly with your children and create a mutual respect when talking about allergies. They will want to ask questions and should use you as a sound board, creating a quick feedback loop. You will be surprised by how young an age a child can take charge of their lives; they deserve more credit than we give them. I would definitely recommend reading this NPR on children as young as 7 learning how to look after themselves

3-    Practice, practice practice

Teaching your child to advocate for themselves is key and it goes hand in hand with self confidence. Building confidence is no different to learning how to play the guitar: one string at a time. Parents should teach their kids how to ask questions about anything; there is no shame in that. Rather than feel like it’s a taboo of some sort, let your kids take pride when it comes to expressing their condition to others. You can then move to their allergy and use roleplay to practice different scenarios where your child can practice explaining their allergy. 

Child Mind Institute has some great tips – If your child is fully confident in asking for a bottle of ketchup at a restaurant, then expressing their allergic condition shouldn’t be any different!

4-    Step up

There is never any shame in objecting to something. Teaching your kids to say no from an early age broadens and strengthens their character. If your child doubts whatever it is they’re about to eat or drink, then they should know they always have the option to say no.

It’s also vital for a parent to teach their child that even adults can sometimes make mistakes. Your children must be comfortable in saying “no” in the case that an adult unknowingly said food is safe when it isn’t. Most kids are programmed to think that they should always listen to adults (teachers included). Still, when it comes to food allergies, children should be supported to make their own decisions when their parents are not around.

Confidence is an underpinning principle when it comes to allergies. By teaching your child how to own their allergy, you’re also empowering them in other areas of their life. I can’t think of a more fitting quote than that from Andrew Solomon to bear in mind when it comes to allergies; “The experience of diversity is more illuminating, more transformative, more powerful, and more important.”

This blog piece was contributed by AllergyAboard (find them here on Twitter). It was started on the belief that allergy translation does not need to be expensive or restricted to single phrases. The site started with 2 allergies and now has over 300 translations online available for free. Find the translation that’s right for you.

April – Articles of Interest

Another month in lockdown here in the UK, I have lost all track of time and have no idea what week we are in! I only just remembered this morning to look at what was published last month with regards to allergy. As we are on a global go-slow there hasn’t been much that caught my eye, but I did enjoy these!

Lemon seed allergy: a case presentation

Mechanisms of eosinophilic inflammation

A Day in the life of an Allergist: Food Allergies

This is a really nice read, by Claudia Gray who is a Paediatric Allergy Consultant in Cape Town

Novel Cross-Reactivity Syndrome: Severe Allergy to Ingested Quorn (Mycoprotein) in a Mould-Allergic Adolescent

Apple Allergy—Development of Tolerance Through Regular Consumption of Low-Allergen Apples. An Observational Study – This is just an abstract, but I have seen apple allergy pop up more and more, you can read more about it here from information compiled by the University of Manchester.

If you spot an article or research that you think would interest me you can message my Facebook page or tag me in a Tweet.

Jemma

March – Articles of Interest

Well this has been a weird month! Our family are in week 4 of self isolation as we were unlucky enough to get the COVID-19 virus early before the UK schools shut down. We are in our second week of attempting to home school a 10 and 8 year old as well as hold down a couple of jobs. We are exhausted, but have all recovered well from the virus (including the 10 year old with asthma).

I hope you are coping as best you can wherever you are in the world.

I haven’t had an in depth look at the published articles this month as I am multi-multi-tasking, but thought I would get them out there as something different for you to read. I guess that some of you, like me, have spent way too much time looking at articles about the pandemic and need a break from it.

Here is what caught my eye from last month.

If you spot an article or research that you think would interest me you can message my Facebook page or tag me in a Tweet.

Jemma

February – Articles of Interest

Cetirizine use in childhood: an update of a friendly 30-year drug. This is the antihistamine my daughter uses on a regular basis during pollen season, so I found this to be an interesting read.

IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. This document covers skin prick tests, intradermal tests and patch testing as well as non-specific IgE testing, specific IgE testing and basophil activation tests (BAT). I found it to be very thorough and informative.

Food hypersensitivity reactions to seafish in atopic dermatitis patients older than 14 year of age – The evaluation of association with other allergic diseases and parameters. This paper suggested a higher occurrence of atopic dermatitis in fish allergic patients as well as sensitisation to fungi and reactions to celery

Nickel allergy to orthopaedic implants: A review and case series. I included a paper last month about titanium allergy after implant.

The role of nutritional factors and food allergy in the development of psoriasis. Just an abstract, but this was interest of me as my sister has suffered with psoriasis since she was a child and has recently given up dairy to try to improve her condition.

Pea (Pisum sativum) allergy in children: Pis s 1 is an immunodominant major pea allergen and presents IgE binding sites with potential diagnostic value. Abstract only, you don’t see many studies on peas.

Allergy to tree-of-heaven pollen in Germany: detection by positive nasal provocation

Association between fruit and vegetable allergies and pollen-food allergy syndrome in Japanese children: a multicenter cross-sectional case series. The most common allergies in children in this study were found to be apple, peach, and kiwi.

Let me know if you found any of these interesting or useful.

If you spot an article or research that you think would interest me you can message my Facebook page or tag me in a Tweet.

Jemma