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Alan Khadavi, MD, APC
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April 3, 2022 by Alan Khadavi

Kiwi Allergy can come in many flavors

Kiwi allergy is not commonly reported, but it can cause adverse reactions.  Hypersensitivity reactions to other fruits are commonly reported, particularly fruits in the birch tree family: apple, hazelnut, carrot and potato, these may be symptoms of oral allergy syndrome.  Kiwi is also known as a Chinese gooseberry. Kiwi has a slightly acidic flavor that can be described as tangy or tart. The berry has a unique flavor that cannot be compared with any other fruit. Kiwi is full of vitamins like vitamin C, K, and E. It is rich in minerals like folate, potassium, fiber (a good source for digestion), omega-3 fatty acids and antioxidants. Kiwi has been implicated in an array of adverse reactions, including uncomfortable mucosal irritation due to acidic pH, oral allergy syndrome and anaphylaxis.

Types of Reactions to Kiwi:

  1. Mucosal irritation-involves the acidic pH of the fruit as well as the proteolytic activity of Actinidain (Actinidin). Actinidain is commercially useful as a meat tenderizer, and in coagulating milk for dairy products. Actinidin, at the levels found in kiwifruit, does not seem to be a major health hazard for most people, but has been associated with local responses to kiwifruit. Actinidin can cause damage to the lips (especially at the corners of the mouth) but only if very large quantities of fruit are eaten. People may also develop a rash in areas where the skin made contact with the fruit.
  2. Oral Allergy Syndrome-symptoms typically occur with mouth itching and swelling of lips and tongue.  Patients allergic to birch tree (Bet v 2) can describe symptoms of oral allergy syndrome to kiwi.  This is not a true kiwi allergy, but a cross reactivity of the proteins to the birch tree pollen.  Treatment is heating the fruit or just avoiding it. Other foods in the birch tree family are apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum.
  3. Latex Cross Reactive Foods-Around half of all people with latex allergy have allergic reactions when eating particular foods, including avocado, banana, chestnut, kiwifruit, passionfruit, plum, strawberry and tomato. This is because some of the proteins in latex that cause latex allergy are also present in these fruits
  4. Anaphylaxis-symptoms that occur are hives, swelling, wheezing, coughing, vomiting, diarrhea and low blood pressure. Of the 13 different allergens identified in green kiwi, five are defined as major allergens. Act d 1, Act d 2, Act d 8, Act d 11, and Act d 12 are defined as the “major allergens.” Allergy skin testing, specific IgE lab testing and fresh food skin testing with kiwi all can be used to test for kiwi allergy. Kiwi is increasingly recognized as a common elicitor of allergic reactions worldwide, and in recent studies, it ranks among the top 10 food allergies in Denmark, Sweden, Estonia, Finland, and The Canary Islands.

Reactions to kiwi can thus come in different forms.  An allergy doctor can help decipher what type of reaction one is having to kiwi and to do the appropriate tests for establishing or ruling out a diagnosis of clinical allergy. Allergy to kiwi can best be evaluated by means of clinical history, skin tests, IgE determinations, and DBPCFCs.

Filed Under: Blog, Food allergy

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Dr. Alan Khadavi
Allergy & Asthma Specialist

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